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系統性、結構式的住院醫師訓練計畫成效初報

Preliminary Report on a Systematic Structured ENT Resident Training Program in Otolaryngology Education

摘要


背景:我國醫學教育近年來歷經重大改革,作為醫師養成的最後階段,專科訓練如何順利銜接醫學院、一般醫學及住院醫師教育,以培養優秀的耳鼻喉專科醫師,是住院醫師訓練計劃的重要課題。本研究欲探討某醫學中心耳鼻喉科將住院醫師教學訓練計畫結構化實施的初步成效。方法:自2010年第1學期開始,個案醫院依據「民國100年版新制教學醫院評鑑」住院醫師訓練規定,將衛生署定「耳鼻喉專科訓練課程」予以結構化,以系統性的進行教學活動。其間進行兩次「住院醫師能力測驗」,並於實施後1年後進行「住院醫師滿意度調查」,依照住院醫師的年資和性別做統計分析。結果:個案醫院共10名住院醫師,第一次「住院醫師能力測試」通過率為70%,第二次通過率為100%,兩次平均成績(60.5±2.4 vs. 78.1±1.5)有明顯進步(p=0.009)。住院醫師對教學活動的整體滿意度平均分數為71.3±6.6分,對「教科書研讀」於專科醫師考試及「學習護照」記錄學習歷程的滿意度平均分數為84±12.6分及78±14.8分,資深住院醫師對於學習護照使用的滿意度高於資淺住院醫師,分別88±11分及64±8.9分(p=0.016)。結論:耳鼻喉科教學醫院訓練計畫應善用所有科內教學資源,結構性、系統性地施予住院醫師教育。本研究提供個案醫院耳鼻喉科住院醫師訓練課程未來改進的方向。

並列摘要


BACKGROUND: Medical education has undergone evolutionary changes during the past decades. As the last phase of a physician's education, to cultivate a proficient otolaryngology specialist, it is critical to articulate medical education from medical school to resident training program. The objective of this study is to present the preliminary results after implementing a systematic, structured otolaryngology resident training program in a medical center otolaryngology--head and neck surgery department.MATERIALS AND METHODS: In accord with the Taiwan Joint Commission of Hospital Accreditation's version of the ”Teaching Hospital Accreditation Standard” (issued by the Taiwan Department of Health in January 2010), we designed and implemented a systematic structured otolaryngology resident training program. Two ”resident proficiency test” were administered during 2010. One year after implementation of the systematic structured program, ”resident satisfaction” was surveyed. We analyze variables (sex and seniority) that may affect resident satisfaction.RESULTS: Ten residents in the department participated. The pass rates were 70% for the first ”resident proficiency test”, and 100% for the second resident proficiency test. The mean (SD) test scores significantly improved between the first test and the second test (60.5[±2.4] vs. 78.1[±1.5], p = .009). The mean (SD) resident satisfaction scores were 71.3 (6.6) for overall teaching activities, 84 (12.6) for ”textbook reading,” and 78.0 (14.8) for ”learning passport use”. Senior residents had higher satisfaction with ”learning passport use” than junior residents (p=.016).CONCLUSIONS: The success of specialist training in a teaching hospital's otolaryngology program relies on the best use of its entire educational resources within the department. A well-organized, systematic, structured resident training program may facilitate successful education. The preliminary results from this study provide us with useful information to further improve our education program.

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