教学专栏

眼科住院医师规范化培训前医师职业认同感调查

A survey on professional identity of ophthalmology residents before standardized resident training

:394-401
 

目的:了解目前眼科住院医师规范化培训前职业认同感现状,并探讨相关影响因素。方法:于2024年7—8月,通过问卷调查法调查64名临床医学眼科住培医师,了解其住院医师规范化培训前的职业认同感现状和影响因素,同时探讨规范化培训对于其职业认同感的影响及作用,通过描述性分析、t检验、单因素方差分析、Pearson相关性分析、多元线性回归分析等方法对相关数据进行分析。结果:规范化培训前,职业认同感评分、职业认知、职业情感、职业承诺、职业行为、职业期望、职业价值观等评分分别为(143.16±12.25)(3.60 ± 0.94)(3.98 ± 0.71)(3.61 ± 1.01)(3.89 ± 0.653.84 ± 0.78)(3.71 ± 0.86)分。规范化培训后,眼科住培医师职业期望评分略有降低,与规范化培训前比较差异有统计学意义 (均P  < 0.01), 其他职业认同度部分条目评分在规范化培训前后比较差异无统计学意义(均P > 0.05)。女生对于眼科医学的职业情感(P = 0.01)及职业价值观高于男生(P = 0.03)。本科时担任学生干部的眼科住培医师职业情感高于非学生干部的学生(P < 0.01)。第一选择为眼科的眼科住培医师的医学职业期望(P  < 0.01)和职业价值观更高((P = 0.02)。而学历、临床医学志愿选择与职业认同感差异均统计学意义(均P > 0.05)。此外,规范化培训一定程度增强了眼科住培医师的显微操作能力和职业信心。结论:住院医师规范化培训前眼科住培医师的职业认同感较高,但仍有待进一步提高。眼科住培医师的职业认同感与职业看法、培训内容、教学资源等因素密切相关。

Objective: To investigate the current status of professional identity among ophthalmology residents before standardized resident training and to explore the influencing factors. Methods: A survey was conducted from July to August 2024 involving 64 clinical ophthalmology residents. The survey assessed their professional identity before standardized resident training and examined the impact and role of pre-residency training on their professional identity. Descriptive analysis, t-tests, univariate analysis, Pearson correlation analysis, and multiple linear regression were used to analyze the data. Results: Before pre-residency training, the scores for overall professional identity, professional cognition, professional emotion, professional commitment, professional behavior, professional expectations, and professional values were (143.16 ± 12.25), (3.60 ± 0.94), (3.98 ± 0.71), (3.61 ± 1.01), (3.89 ± 0.65), (3.84 ± 0.78), and (3.71 ± 0.86), respectively. However, after pre-residency training, the score for professional expectations among ophthalmology residents decreased slightly (P < 0.01), while no significant statistical differences were observed in other items related to professional identity (all P > 0.05). Female residents had higher scores in professional emotion (P = 0.01) and professional values (P = 0.03) than male residents. Ophthalmology residents who had served as student leaders during undergraduate studies had higher scores in professional emotion (P < 0.01). Residents who chose ophthalmology as their first preference had higher scores in professional expectations (P  < 0.01) and professional values (P = 0.02). However, no significant differences were found among educational levels, clinical medicine preferencesand professional identity. In addition, pre-residency training enhanced the residents micro-surgical skills and professional confidence. Conclusions: The professional identity of clinical ophthalmology medical students before standardized resident training is relatively high but still needs improvement. Professional identity is closely related to factors such as professional views, training content, and teaching resources.

论著

高度近视有晶状体眼后房型人工晶状体术后孔源性视网膜脱离的临床特征及预后分析

Clinical presentation and outcomes of rhegmatogenous retinal detachment in phakic eyes after posterior chamber phakic intraocular lens implantation for high-myopia

:111-116
 
目的:分析高度近视有晶状体眼后房型人工晶状体植入术后孔源性视网膜脱离的临床特征及预后。方法:回顾分析2012年4月至2021年6月中山眼科中心收治的9例(9只眼)行后房型人工晶状体植入术后孔源性视网膜脱离患者的临床特征、手术方式及疗效,随访(4.96±4.78)个月。结果:患者年龄(30.44±20.11)岁,屈光手术至发病时间(32.10±17.80)个月。4例(44.4%)马蹄形裂孔,1例(11.1%)萎缩性裂孔,4例(44.4%)巨大裂孔;9眼裂孔均位于赤道部前,除2眼(22.2%)为单个巨大裂孔,1眼(11.1%)单个马蹄孔,余6眼(66.7%)均有视网膜周边变性区存在;视网膜脱离范围(3.0±1.12)个象限,8例累及黄斑;增殖性玻璃体视网膜病变C级以上4眼。视网膜初始复位率为77.8%,最终视网膜复位率100%。末次随访最佳矫正视力优于术前(P<0.05)。随访期间,2例硅油填充眼发生并发性白内障,4眼发生术后早期高眼压。结论:有晶状体眼后房型人工晶状体植入术前存在的视网膜变性或术后玻璃体牵引的存在可能是孔源性视网膜脱离发生的危险因素。
Objective: To analyze the clinical presentation, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD) in patients with high-myopia corrected by posterior chamber phakic (PCP) intraocular lens (IOL) implantation. Methods: Nine eyes of 9 patients in whom RRD developed after PCPIOL implantation from April 2012 to June 2021 in Zhongshan Ophthalmic Center were retrospectively studied. Mean follow-up after retinal detachment surgery was (4.96±4.78)months. Results: Mean patient age was (30.44±20.11) years old. RRD occurred (32.10±17.80) months after PCPIOL implantation. Four (44.4%) breaks were horseshoe tear, 1 (11.1%) was atrophic hole and 4 participants (44.4%) had a giant retinal tear. Nine cases had causative breaks located anterior to the equator while peripheral retina lattice degeneration was found in 6 eyes. RRD extended from 1 to 4 quadrants (3.0±1.12 quadrants) and 8 cases were macula-off retinal detachments. Four eyes’ proliferative vitreoretinopathy were more severe than level C. Initial reattachment rate was 77.80%. Final retinal reattachment was 100%. Final follow-up BCVA was significantly better than baseline (P<0.05). Furthermore, concurrent cataract occurred in 2 eyes in which silicone oil was used as tamponade. Ocular hypertension was detected in 4 eyes after surgery. Conclusion: The existed lattice degeneration and postoperative vitreous traction may be risk factors for RRD after PCPIOL implantation.
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
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  • 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
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