论著

眼科住院医师委托培养效果的评估研究

Study of the effectiveness of entrusted standardized training for ophthalmic residents

:251-258
 
目的:住院医师委托培养是我国医学教育标准化和国际化的重要举措。本研究采用客观考核和主观问卷两种方法评估我国眼科住院医师委托培养效果。方法:本研究对象为广东省深圳市政府于
2012年8月至2015年7月期间委托中山大学中山眼科中心进行眼科住院医师规范化培训的9名学员。本研究对所有学员的基本信息、临床培训情况、以及考核成绩等客观指标进行统计分析,同时设 计了一份包含13个问题的调查问卷,对每位学员的培训情况进行主观评估。结果:本研究纳入9名研究对象,包括2名男性和7名女性,平均年龄为(26±3)岁,学历水平情况为学士7名和硕士2名,其中有7名毕业于国家重点医学院校。3年内人均轮转眼科亚专科超过10科,平均主管病人数及参加手术例数分别为736和1 219例,门诊工作总量人均6 274人次,所有学员均按规定至少完成综 述1篇。8名(88.89%)学员认为可以独立诊断并治疗大部分常见眼科疾病,而且能独立完成大部分眼科基本临床操作,5名(55.56%)学员可以单独完成翼状胬肉切除术、霰粒肿刮除术、前房穿刺术等。6名(66.67%)学员认为培训时间安排合理。8名(88.89%)学员对这次委托培养总体比较满意。 所有9名培训学员中,最终有7名(77.8%)顺利通过中山大学第一阶段住院医师规范化培训考核。结论:培训学员对现行的眼科住院医师规范化培训方案的接受程度较高,基本达到预期的培训效果,对常见眼病能独立进行诊治。委托培养学员的学历和学习能力的差异在一定程度上影响了最终的培训考核通过率。
Objective: The entrusted standardized training for residents is an important measure to gear the medical education in China to the international conventions. In this study, the effectiveness of standardized training for entrusted ophthalmic residents in China was evaluated both objectively and subjectively. Methods: Nine ophthalmic residents, commissioned by Shenzhen government of Guangdong Province, studied at Zhongshan Ophthalmic Center, Sun Yat-sen University during August 2012 to July 2015 were included in this study. The objective indicators of all participants were analyzed, including the basic information, clinical training, the score of examination, etc. The subjective self-assessment was also implemented thought a questionnaire including 13 designed questions.Results: All 9 participants included 2 males and 7 females, 2 medical masters and 7 bachelors, and the mean age was 26±3 years. Seven of them graduated from the national key medical universities. The mean number of rotated sub-clinical departments was 10.3, the mean number of managed inpatients and the participated operations were 736 and 1,219, respectively. The total number of managed outpatients was 6,274 in average. All participants completed at least one review article. Eight (88.89%) participants could independently diagnose and treat the most common ophthalmic diseases, they also could complete the basic clinical ophthalmic operation independently. Five (55.56%) participants could independently manage the pterygium excision, curettage of chalazion, anterior chamber penetration, etc. And 6 (66.67%) of the participants believed that the training length was reasonable. Eight (88.89%) of them were satisfied with the standardized training for residents on the whole. Finally, 7 participants successfully passed the first stage of standardized training program in Sun Yat-sen University. Conclusion: There was a high level acceptance rate of the standardized training programs for entrusted ophthalmic residents. The participants achieved the expected training effects, and could managed the diagnosis and treatment of common ophthalmic diseases independently. But the training effects and passing rate of examination were partly affected by the learning ability of the training students.
论著

眼专科医院患者突发急症分析

Analysis of medical emergencies of patients in ophthalmic hospitals

:792-797
 
目的:分析眼专科医院患者突发急症现状,并探讨防控措施。方法:回顾性分析2017—2018年中山眼科中心82例突发急症事件,具体分析突发急症事件的特点、处置情况及患者转归。结果:眼专科医院中最常见的突发急症事件为药物不良反应(n=38,46.3%),其后依次是晕厥(28.0%)、心脑血管急症(8.3%)、意外事件(6.1%),其中药物不良反应涉及的相关药物最多见于荧光素钠注射液(n=16,42.1%)、局部神经阻滞麻醉相关药物(n=7,18.4%)。突发急症事件集中分布于工作时段8:00—18:00(n=74,91.3%),非工作时段多见于药物不良反应(n=3,42.9%)及心脑血管急症(n=3,42.9%)。门诊是突发急症事件最常发生的场所(n=53,64.6%),其后依次是住院病房(22.0%)、手术室(11.0%)。患者突发急症危急程度轻、中、重度分别占92.7%,4.9%,2.4%。50%的患者需要综合医院急诊人员配合抢救或至综合医院进一步诊治。结论:通过优化患者诊治流程,缩短在院时间,医护人员提高预警意识,明确各岗位潜在急症风险,可降低突发急症事件发生风险。发挥麻醉师专业优势,提高院内应急处理能力,同时签约定点综合医院急救服务,为患者提供快速、准确、高效的救护,保障患者生命安全。
Objective: To analyze the status of medical emergencies of patients in ophthalmic hospitals and put forward suggestions on their prevention and control measures. Methods: The medical emergencies of 82 patients in ophthalmic hospitals in 2017 and 2018 was been analyzed retrospectively, and the characteristics and treatment of emergencies as well as the metastasis and progression of the disease in patients were analyzed specifically.Results: Medical emergencies were caused by druginduced adverse reaction (n=38, 46.3%), syncope (28.0%), cardiovascular emergency (8.3%), accidents (6.1%) in sequence. Fluorescein sodium (n=16, 42.1%) and local anesthesia drugs for nerve block (n=7, 18.4%) were the most common drugs related to drug adverse reaction. Most cases happened at 8:00—18:00 (n=74, 91.3%), and drug adverse reaction and cardiovascular and cerebrovascular emergencies were most common at 18:00—8:00. Medical emergencies happened in outpatient department (n=53,64.6%), wards (22.0%) and operation rooms (11.0%). There were mild emergencies (92.7%), moderate emergencies (4.9%) and severe emergencies (2.4%) in patients. Among them, 50% of patients need first aid by doctors from general hospitals or to be transferred to the general hospital for further treatment. Conclusion: Through optimizing process, shortening the hospital stay, identifying potential risks and enhancing medical workers’ awareness of safety, the risk of medical emergencies can be reduced. We should give full play to the professional advantages of anesthesiologists,improve the emergency handling capacity of the hospital, and contract the emergency services of designated general hospitals to provide rapid, accurate and efficient rescue for patients to ensure the life safety of patients.
论著

眼科住院医师规范化培训学员沟通技能态度与人际沟通能力的现状和相关性

Current status and correlation between attitudes and competency of interpersonal communication in ophthalmology standardized training trainees

:627-635
 
目的:了解眼科住院医师规范化培训学员(规培生)的沟通技能态度和人际沟通能力现状。法:对中山大学中山眼科中心三个年级规培生的沟通态度和人际沟通能力进行问卷调查,并进一步分析其沟通态度与沟通能力的相关性。结果:共纳入196名规培生,沟通积极态度量表总分为51.38±6.52,消极态度为36.80±5.70,人际沟通能力为2.41±0.40,辅导与咨询维度得分为2.50±0.64,提供有效的负面反馈维度得分为2.61±0.50,支持性沟通维度得分为2.29±0.44。沟通技能的积极态度与人际沟通能力和三维度之间显著相关(P<0.01)。人际沟通技能得分与性别、规培年级、喜欢眼科专业的程度、得到家庭的关爱程度、得到朋友的关爱程度等因素显著相关(P<0.05)。结论:眼科规培生对沟通技能的积极态度优秀,但是总体沟通能力较弱,并受到多种因素影响。应充分重视规培生人际沟通能力的培养,开展医患沟通的专业化培训。
Objective: To evaluate the current status and correlations between attitudes and competency for interpersonal communication in ophthalmology standardized training trainee. Methods: A questionnaire survey was conducted on the communication attitudes and interpersonal communication ability of standardized training trainees from three grades in Zhongshan Ophthalmic Center, affiliated to Sun Yat-sen University, and the correlation between communication attitude and communication ability was further analyzed. Results: A total of 196 trainees were included. The scores of positive attitude, negative attitude, and interpersonal communication skills were 51.38±6.52, 36.80±5.70, and 2.41±0.40, respectively. In addition, the dimension of coaching and counseling scores were 2.50±0.64, the dimension of providing effective and negative feedback scores were 2.61±0.50, and the dimension of supportive communication scores were 2.29±0.44. The positive attitudes of communication skills were significantly related to the interpersonal communication skills and three-dimensionality (P<0.01). The interpersonal communication skills were significantly associated with sex, grades, interest in ophthalmology, social support from the family and friends (P<0.05). Conclusion: Ophthalmology trainees have excellent positive attitudes toward communication skills, but the overall communication skills are weak and influenced by a variety of factors. More attention should be paid to the development of interpersonal communication skills of the trainees, and specialized training in doctor-patient communication is warranted.

其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
推荐阅读
出版者信息