目的 从住院医师和临床医学硕士专业学位研究生两类培训对象角度,以岗位胜任力为导向,调查医教协同政策实施后北京市住院医师规范化培训的效果.方法 对已完成2016—2019年住院医师规范化培训并参与结业考试的培训对象的基本情况、培训完成情况和培训能力提高情况等进行问卷调查.结果 2019年参与北京市住院医师规范化培训效果调查的3084名对象中66.67％为住院医师,33.33％为临床医学专业硕士学位研究生.经过住院医师规范化培训,两类培训对象的各项能力都有所改善,其中职业素养改善效果最显著,培训效果呈现显著差异,住院医师的整体培训效果优于临床医学硕士专业学位研究生;影响两类培训对象培训效果的因素无显著差异.结论 医教协同政策实施后,建议进一步探索更加满足两类培训对象不同需求的住院医师规范化培训模式,进一步提高住院医师规范化培训同质化.

伦理审查互认是多中心临床研究发展的必然趋势.在北京市卫生健康委员会的领导下,北京市医疗机构自愿组建北京市医学伦理审查互认联盟,制订《北京市医学伦理审查互认联盟工作规则》和《北京市医学伦理审查互认细则》.北京市医学伦理审查互认采用协作审查模式,互认范围从药械临床试验扩展到所有临床研究项目;同时也推出了统一的伦理审查申请相关文件清单等模板,以节约申办者和研究者准备资料的时间;创建了伦理互认信息平台,使伦理互认各方有了可依托的工作载体,互认信息公开透明,便于相互监督,利于政府监管.北京市医学伦理审查互认可为多中心临床研究伦理审查互认模式在全国的推广提供参考.

目的:了解医教协同政策实施4年来北京市住院医师规范化培训现状,系统地总结经验与不足.方法:2019年4月,对北京市完成住院医师规范化培训并进行结业考核的全体学员进行在线网络问卷调查,结合结构化访谈方法,并与2018年横断面调查结果进行对比,采用描述性统计和秩和检验进行数据分析.结果:2019年北京市共有3084名学员完成住院医师规范化培训,其中住院医师2056人(66.67％),专硕生1028人(33.33％),培训开展和完成情况均达到85％以上,与2018年相比,培训出科考核开展情况、住宿条件、补贴水平均得到显著改善.结论:北京市稳步推进医教协同培养模式下的住院医师规范化培训工作取得了不错成效,在优化医学人才培养结构、提高医学人才综合素质、完善考核制度、落实配套措施等方面还需各项改革措施齐头并进,继续完善培训机制.

Objective To establish the quality control system of the Capital's Funds for Health(CFH),strengthen the process management,and improve the clinical research capacity.Methods The framework,contents and implementation method of the quality control system were developed with comprehensively adopting methodologies of literature analysis,expert discussion,summaries of policy and practice experiences.Results This quality control system of the Capital's Funds for Health is comprised of three tiers.The first tier is self-assessment,the principle investigator takes the responsibility;the second tier is the sponsor verification,the sponsor organization takes the responsibility;the third tier is the independent audit,the CFH office takes the responsibility.The contents of quality control focus on the compliance with ethical approval and informed consent,data authenticity,protocol deviation,progress of project,and quality assurance methods taken during the project implementation.Conclusions This three-tier quality control system of the Capital's Funds for Health provides a new idea and scheme for the quality control of clinical research projects supported by funding agencies in China,and its impacts will be evaluated in next implementation practices.

提高伦理审查效率和质量是国家政策和行业发展的需要,单一伦理审查是实现路径之一,推行单一伦理审查具有可行性和实际意义,但是进展不尽如人意.通过开展调查,试图了解阻碍单一伦理审查推行的原因和可能的解决办法.结果显示,大部分医疗卫生机构虽然对单一伦理审查的政策有了解,但是大部分持观望态度;政策保证和各机构伦理审查质量较高且具有同质性被认为是实现单一伦理审查的必要条件.

Objective Discussion on the methods of retrospectively selecting peer review experts based on the results of review.Methods Based on the review data of peer reviewers,peer review experts are retrospectively selected based on the voting,rating and comprehensive evaluations,as well as their variations and errors during the review.Results Through the retrospective selection of peer reviewers,there is a better convergence of reviews,which assures the quality of future peer reviews.This method is superior to the prospective selection of peer reviewers.Conclusions Based on the results of the review,retrospective selection of peer review experts is feasible and helpful for the selection of high-level peer review experts,which can improve the quality of peer review and standardize peer review.

目的:拟分析研究者发起的临床研究中存在的知情同意书签署问题.方法:对北京市2016年立项的所有三甲医院首发专项(capital's fund for health improvement and research,CFH)资助的临床研究项目进行了核查,对出现的所有知情同意问题进行归类判定.结果:本研究纳入的临床研究项目共计198项,出现知情同意签署问题的项目数为86项(43.4％).其中,未签署知情同意书的项目49项(24.8％),签署不规范的项目65项(32.8％),两类问题都存在的项目数为28项(14.1％).所有随机对照临床试验(RCT)均设计了知情同意书,13.1％其他类型研究缺乏知情同意书,但RCT研究其他签署细节问题更严重(47.2％ vs27.6％,P＜0.05).结论:研究者发起的临床研究中,知情同意书签署问题较多,需引起相关部门的足够重视,加强立法和人员培训等.

Objective:To evaluate the status and problams of the basic clinical competence of surgical residents in Beijing. Methods:250 surgical residents having finishaol two-year stand ardized examination participated in the competition. The competition was divided into prelimina-ry, semi-finals and finals. The assessment content included medical knowledge, history inquiry, physical examination, supplementary exam inter-pretation, clinical thinking, medical documents record, medical explanation, communication skills, surgical operation and medical related laws. Each station used percentile rating scale with each scoring points 2 to 3. Results:The 250 surgical residents were from 23 training bases. The to-tal average score of preliminary competition was (295. 38±32. 88), and the passing rate was 27. 6% according to 80 percentile calculation. The scores of residents from suburban hospitals were significantly lower than that of National Health and family Plan Commission system and Beijing's municipal health bureau systems (P<0. 05). The rate of all residents' progress into the semi-finals was 35. 2%, and that of residents with doctor degree was the highest (54. 81%). The residents from National Health and family Plan Commission system was the highest (53. 19%) , followed by Beijing's municipal health bureau systems, Peking University system, military university systems and district hospitals. The total average score of semi-finals was (233. 98±25. 15), and the passing rate was 42. 5% according to 60 percentile calculation. The score of finals with team oper-ation was (89. 05±5. 17), and the passing rate was 60. 00% according to 80 percentile calculation. Conclusion:The core competence of surgical residents in Beijing is needed to be improved, and there are some differences in different resident training base. It is urgently needs to strengthen the clinical training, construction of teaching faculty and management of the training base.

This article applied stochastic frontier analysis to estimate the efficiency of the 2007 Beijing Medicine Development Foundation,and analyzed the dominant influencing factors of the performance.The following results were found out..(1) The performance of 2007 Beijing Medicine Development Foundation was good in general,however there was a 23％ gap between the actual output and the frontier output.As time passes by,the expected performance will get better.(2) There are large differences existed between various categories of projects and the different levels of institutions and project leaders.The relatively high profile projects,which means large input and more complexity,requires higher level of facility and environmental support,project manager's degree,professional title,while technical efficiency is not obvious for small scale independent innovation projects.

Objective To investigate the cognition of organizations who undertake the programmes of Capital medical development research foundation (referred to Capital Fund).Methods We formed electronic questionnaire mainly by the Expert Meeting Law,and investigate the cognition of the project undertaker of Capital Fund,relying on the special work notice of Beijing Municipal Health Bureau.We evaluated reliability by analyzing Cronbach's alpha coefficient,evaluated validity by content validity,and analysis the project undertaker's cognition of the function,satisfaction,purpose and influence of Capital Fund.Results The satisfaction index with method of the foundation's management and the cognition index to the foundation are both over 93 percent,the objective and the impact of Capital Fund are popular,showing that the Capital Fund promoted the development of medicine.Conclusions The organizations undertaking the programmes of Capital Fund have positive cognition and satisfaction to the foundation,and the project leaders also showed their expectation to the foundation.

Objective To investigate the cognition of persons who lead the programmes of Capital Medical Development Research Foundation (referred to Capital Fund).Method We formed electronic questionnaires mainly by the Expert Meeting Law,and investigated the cognition of the project leader of Capital Fund,relying on the special work notice of Beijing Municipal Health Bureau.We evaluated reliability by Cronbach's alpha coefficient,evaluated validity by content validity,and analyzed the project leader's cognition of the function,satisfaction,purpose and influence of Capital Fund.Result The satisfaction index with method of the foundation's management and the cognition index to the foundation are both over 95％,the objective and the impact of Capital Fund are popular,showing that the Capital Fund promoted the development of medicine.Conclusion The project leader of Capital Fund have positive cognition and satisfaction,and also showed their expectation to the foundation.

Objective The purpose of this study was to evaluate the written project approval Indexes System of Capital Medical Ddevelopment Research Foundation.We analyzed the approval results of application projects and proposed measures to improve the index system.Methods We evaluated its reliability with Cronbach's alpha coefficient,split-half reliability; validity was evaluated with contract validity and content validity,discrimination was studies according to discretion grouping law,and feasibility was studied with the percentage-of-completion method.Results ① Reliability:Cronbach's alpha coefficient of factor and total scores'and split-half reliability were all over 0.80.②Contract validity:the standard factor loading coefficients of the index system were over 0.70 (range:0.57～0.86),indicating path performed well.All factor loading coefficients were statistical significant (T-values were 30.49～54.25,all were over 1.96).Fit Indexes (RMSEA =0.065、NNFI =0.99、IFI =0.99、CFI =0.99、GFI =0.95、AGFI =0.93、X2 =1028.21、X2/DF =11.82) indicated the system's goodness of fit was good.③ Content validity:Scale-level CVI,S-CVI was 0.97 and Interrater agreement was 0.93,over 0.90,which indicated that indexes system's whole Content validity performed well.Except for the item Academic thought item-level CVI being 0.57 all items' item-level CVI were 1.00.④Discrimination:Discrimination index of every primary index,secondary index and total score ranged from 0.51 to 0.76 (all were over 0.40),meaning that discrimination performed extremely well.Conclusion The indexes system's reliability,contract validity,content validity and discrimination conformed to the actual application projects appraisal results.

<正>随着我国继续医学教育稳步、快速的发展,北京市继续医学教育工作也进入了全面发展的新时期,为提高北京地区卫生技术人员医疗水平和服务质量、促进医药卫生体制改革发挥着越来越重要的作用。北京市继续医学教育工作的做法可用三个字概括,即"严、实、新"。严是严格管理、实是坐实基础、新是创新发展。"十一五"期间,北京市继续

为了解北京市亚运村社区居民环境满意度的变化情况,于2006年11月-2008年11月,对亚运村社区的15周岁以上常住居民和暂住居民的环境满意度(包括空气质量、城市绿化、垃圾处理、食品质量、饮水质量).结果显示,2007年和2008年亚运村社区常住居民在环境各领域表示满意的报告率均高于2006年,2006年暂住居民各项环境满意度均高于常住居民,差异有统计学意义(P＜0.01).提示奥运期间亚运村社区居民环境满意度有显著提升.

Objective: To establish a scientific and feasible index system for evaluating the key clinical medical subjects.Methods: Using Delphi method and expert consultation method,the assessment indexes and weight coefficient of each index were determined.Results:The index system was developed,which included five first-class(primary) indexes,thirteen second-class indexes and 43 three-class indexes,also the mathematics model of comprehensive assessment was proposed.Conclusions: The constructed assessment indexes are representative and the weight coefficient of each index is reasonable.Therefore,it could provide a scientific and objective reference mode for evaluating the key clinical medical disciplines in the future.

Objective To know the status of environmental and life among residents living in Yayuncun community in Beijing.Methods 1?641 permanent residents above 15 years old from 600 families inhabiting in the Yayuncun community since the year of 2000 were selected into the cohort in 2006 to answer Beijing Typical Community Resident Questionnaire designed by the researcher.The residents' basic information,environmental and life and other information were collected and 1?583 permanent residents were followed up in 2007.Meanwhile,333 and 410 temporary residents were investigated used the same questionnaire in 2006 and 2007,respectively.Results The rates of environmental and life were higher among permanent residents in 2007 than in 2006(P0.01).The top 3 aspects with the highet rates among permanent residents in 2006 were total life satisfaction,green space and family housing condition,the rate was 50.6%,48.4% and 39.1%,and in 2007 were green space,total life satisfaction and water quality,the rate was 64.0%,56.5% and 48.5%,respectively.The rates of environmental and life had no significant difference among temporary residents between 2006 and 2007(P0.05).Multivariable linear regression showed that medical insurance type,permanent resident or temporary resident,different year were independent factors of environmental and life satisfaction(P0.01).Conclusion All of the components of environmental and life degree were increased in 2007,and the environmental amelioration of community would impact the life of residents.

Objective To know the situation of health state and the influence of the Olympics among typical community residents in Beijing.Methods In 2004 and 2005,1765 permanent residents above 15 years old of 600 families inhibiting in typical communities since the year of 2000 were selected to answer Typical Community Resident Questionnaire designed by the researcher and the residents' health state were analyzed.We carried out the follow-up investigation with the same questionnaire in 2006 and 2007.Results Hypertension was the main chronic disease among the typical community residents in Beijing,and the prevalence was 23.5%,25.5% and 24.0% in baseline,2006 and 2007,respectively.The prevalence of coronary heart disease was 8.7%,7.3%,and 9.8% in the different years,and that of diabetes was 7.5%,7.9% and 9.4%,respectively.The prevalence rates of the three chronic diseases among people never participated in physical exercise were 33.5%,33.1 and 27.8%,however,among people participated in physical exercise were 8.9%,8.2% and 10.4% in the different years.The self-reported rate of good heath condition was 48.7%,47.4 and 47.7%,respectively.Conclusion With the 2008 Olympics coming and the healthy Olympics,healthy Beijing program,the health state of community residents in has been improved.

Objective To know the status and the trends of health behaviors among residents in Yayuncun community in Beijing,and evaluate the effects of Olympic Games on the health of the residents of the host city.Methods 1641 permanent residents above 15 years old of 600 families inhibiting in typical communities since the year of 2000 were selected to answer Beijing Typical Community Residents' Questionnaire designed by the researcher through which the residents' health behaviors were understood and followed up in 2006 and 2007 and surveyed with the same questionnaire.Results Compared with the data of baseline and 2006,the percentage of fresh vegetable and high-quality protein intake were higher among community residents in 2007 and the percentage of high-salt and high-fat food intake was lower in 2007(P0.05).There were no significant difference between the results of different years.The percentage of riding bicycle with risk behaviors decreased year by year(P0.01).The prevalence of allergic symptom,insomnia decreased year by year(P0.01).Conclusion The status of health-related behaviors,safe traffic behavior and health condition were improved in 2007 compared with baseline and 2006.

Objective To know the status of utilization of sport facilities in Yayuncun community in Beijing.Methods 1765 permanent residents above 15 years old from 600 families inhabiting in the Yayuncun community since the year of 2000 were selected into the cohort to answer Beijing Typical Community Resident Questionnaire designed by the researcher.The residents' health knowledge,health behavior,health status,physical activity and the usage of sport facilities were surveyed.And the cohort was followed-up through 2006 and 2007.Results The average area of sport facilities per person in Yayuncun community was 1.55 m2.The prevalence of often utilizing the sports facilities near the residence among residents in Yayuncun community was higher in 2007(24.1%) than in the baseline(18.1%) and 2006(22.3%)(χ2=6.407,P0.05).The sports facilities located in the communities were the first choices for residents.The prevalence of exercising with the communities' sport facilities among residents were higher in 2006(41.4%) and 2007(44.5%) than in the baseline(36.0%)(χ2=36.993,P0.01).The satisfaction degree focused on the quantity,quality,open time,charge standard and security of the sport facilities increased in 2007 compared with 2006 and the baseline.Logistic regression showed that educational level,accessibility of the sport facilities,satisfaction for the number and security of the sport facilities were independent factors for the utilization of the sport facilities(P0.01).Conclusion In order to meet the growing demand of physical exercises of the residents,the Yayuncun community should increase the categories and quantities,as well as strengthen the management of sport facilities.

Objective To study the application of an indicator system in evaluating the impact of 2008 Olympic Games on healthy environment in Beijing.Methods Changing rate and trend of varied indicators during the few past years were compared.The influence of 2008 Olympic Games on healthy environment in Beijing was preliminarily evaluated with the established indicator system,based on the data collected from 2001 to 2004.Results The magnitude and speed of changes in healthy environment indicators during the period of preparing 2008 Olympic Games were more and faster than those during the bidding period.And,the magnitude and speed of changes in healthy environment indicators during bidding period were more and faster than those before it.Chain index of overall scores for healthy environment indicators in Beijing during 2001 to 2004 was more than unity,with an annual increase of 8.41 percent.Conclusion Healthy environment in Beijing has been improved remarkably through preparing 2008 Olympic Games.It is effective and adequate to use such an indicator system for evaluating the impact of Olympic Games on healthy circumstances in hosting city.