目的 探讨改良版迷你临床演练评估(mini-clinical evaluation exercise,Mini-CEX)在住院医师出科考核中的作用.方法 选择北京大学第三医院2014年至2019年共2080份住院医师出科考试成绩和改良版Mini-CEX测评结果作为研究资料,探究改良版Mini-CEX八项测评指标对出科考核成绩的影响.结果 改良版Mini-CEX各测评指标均与出科考试成绩呈现正相关(均P<0.001),其中问诊技巧、组织效能和体格检查对出科考试成绩影响较大(均P<0.05).反馈内容中"知识"关键词出现频率随着评价次数增加呈现上升趋势(P=0.013).随着住院医师参加出科考核次数的增加,改良版Mini-CEX评分和出科考核成绩均有所上升,其中组织效能、整体表现和出科考试成绩有明显上升(P=0.012;0.030;0.016);对住院医师规范化培训结业考试通过率分析,发现自2017年开始保持较高水平.结论 基于改良版Mini-CEX的出科考核体系能够有效提高住院医师培训质量,但是仍需加强临床教师培训与信息化建设,完善质量评价体系.

联合应用计划-执行-检查-处理(plan-do-check-act,PDCA)循环、人工智能(artificial intelligence,AI)及标准作业程序(standard operation procedures,SOPs),形成基于AI的教学管理PAS(PDCA-AI-SOPs)模式,探索其在住院医师规范化培训出科考核管理中的应用.PAS模式运行后,对386名教师及676名出科考核学员进行问卷调研,82.9％的教师和88.3％的学员表示满意;PAS管理模式前后各32场次出科考试督导评价得分为(19.11±0.63)分和(19.48±0.59)分,差异有显著性(t=-2.425,P=0.018).PAS模式能够有效优化住院医师规范化培训出科考核环节,提升培训考核质量.

Objective:To realize the characteristics of postgraduate students applying for Peking University Third Hospital and to explore the strategies to improve the enrollment quality on the background of "Double first-class".Methods:Enrollment data from 2015 to 2019 of the Peking University Third Hospital was statistically analyzed by SPSS 17.0 software. For variables that did not conform to the normal distribution, median and quartile were utilized for description. Mann-Whitney U test was utilized for comparison between admission group and non-admission group. For the counting data, number of cases and proportion were utilized for description. The comparison between groups was performed by chi-square test or Fisher precision test. All tests were two-sided and had a significance level of 0.05. Results:The average enrollment ratio was 4.9∶1. The overall admission rate of first choice was 76.9% (450/585), which kept increased steadily, and the gap between national key clinical specialties and non-key specialties was narrowed. The geographical distribution of students was mainly in north China (30%, 175/585) and east China (28%, 164/585). The admission group had characteristics of high score of CET-6 (505 vs. 480, Z=-5.86, P<0.001) and young age (24 vs. 25, Z=-8.15, P<0.001). The proportion of "985", "211" or "Double first-class" universities, patents invention, conference speeches and high level awards in admission group was higher than that in non-admission group. Conclusion:Sustainable policies should be taken to constantly improve the quality of enrollment including establishing sound mechanism of discipline adjustment and optimization, increasing the publicity of enrollment nationwide, and strengthening the selection of the comprehensive ability of students centered on the construction of first-class disciplines.

Objective:To evaluate candidates for academic doctor degree in the view points of their application and entrance process in a university hospital in Beijing and to explore the related factors, so to provide suggestions to improve the quality of students.Methods:A retrospective study was conducted covering 1 028 academic doctoral degree candidates from 2014 to 2019. According to the examination results and admission threshold, they were divided into group A (failed to pass first examination, 560 students), group B (failed to pass retrial, 260 students) and group C (admitted group, 208 students). The graduated school, English language proficiency, academic achievements and comprehensive quality were analyzed. Variance analysis and Kruskal-Wallis rank sum test were used to compare the differences among each group.Results:The proportion of students in groups A, B and C who graduated from "double first-class" colleges and universities were 53.5% (299/560), 61.2% (159/260) and 65.9% (137/208) respectively; the percentage of those with excellent English proficiency were 25.2% (141/560), 23.1% (60/260) and 30.2% (63/208), respectively; the academic achievement scores were 1(0, 5), 1(0, 8) and 2(0, 27) points; the comprehensive quality scores of students in group B and group C were 43.8(40, 50) points and 48.8(43.8, 56.3) points respectively. The differences were statistically significant (all P<0.05). Conclusions:In current admission system, the thresholds of re-examination and matriculation are significantly related to the graduate school, English level, academic achievements and comprehensive quality. Outstanding students in the above aspects are more likely to be admitted. It is suggested to focus on strengthen the assessment of comprehensive quality to screen out students with mental health, sound personality and strong ability to resist pressure

This study is aiming for improving the capacity building of graduate supervisors of clinical medicine through application of "Deming cycle" in Peking University Third Hospital. The improvement of training outcome is focused on four issues as top-level design, training implementation, feedback and improvement. The study showed that the training system for graduates' supervisors based on Deming cycle is effective. Medical schools should establish a complete, standardized and scientific training system for the construction of supervisors' team by improving the management system, the overall quality of the training team, and strengthening the construction of the training connotation. Thus comprehensively improving the quality of training.

Background The COVID-19 outbreak has exerted an enormous impact on various industries worldwide. During this pandemic, clinical teaching hospitals have faced unprecedented challenges regarding the management of postgraduate medical students since postgraduate students in clinical medicine have both student and resident identity characteristics. The purpose of this study was to explore the management effectiveness of Peking University Third Hospital (PUTH) based on PDCA (plan-do-check-act) cycle management and to further develop the medical student management system during the pandemic. Methods The methods of document review, questionnaire surveys and interviews were used to continuously improve the management measures for postgraduate medical students during the COVID-19 pandemic by using the PDCA cycle. Results Investigations were conducted on the management system, back-to-school arrangements, laboratory management, COVID-19 prevention and control training, online teaching, mentoring, dissertation progress, and emotional state of postgraduate medical students during the COVID-19 pandemic. We found that strengthening public health management knowledge training, increasing infectious-disease-related knowledge training, innovating online teaching methods, improving PDCA management model maps, and formulating improvement programmes are conducive to improving the quality of such management. Conclusion Given the difficulties involved in the management of postgraduate medical students during the COVID-19 pandemic, managers need to comprehensively consider and conduct overall planning and use the PDCA management model to improve the management of postgraduate medical students during this period.

Objective:To create the dissertation self-examination items used by medical graduates, and to lay the foundation for dissertation quality assurance system.Methods:The dissertation items for self-examination were put forward by brain storming and panel discussions. Fifteen senior experts were invited to join the project according to the topics of dissertation examination. Delphi method was utilized.Results:Two rounds of inquiries and two rounds of expert consultation were conducted. All the 15 questionnaires in the first round were collected, and 14 questionnaires in the second round were collected. The degree of expert authority was over 0.9. Fifty-three items of self-examination of medical dissertations were accepted.Conclusions:The experts of self-examination of dissertation had high authority and were interested in this topic. The selected self-examination items have certain effectiveness and practicability, which provides a basis for the construction of dissertation quality assurance system.

The quality assurance of dissertations is an important part of graduate training, and the core value of dissertations lies in the contribution to innovative knowledge. Since 2018, based on the concept of total quality management, Peking University Third Hospital has actively implemented full participation, process-spanning management, all-sided quality management, IT-based smart management and gradually established a quality assurance system for dissertations. The project has achieved good results in improving the quality of dissertations, especially in ensuring the academic ethics of dissertations. From 2016 to 2020, the duplication rate of dissertations generally showed a downward trend. Establishing scientific culturing system, fully mobilizing all staff to participate in the whole process, forming a rigorous and innovative academic atmosphere, and continuously improving the quality of dissertations are very important to cultivate qualified innovative medical talents.

The teachers in research positions play an important role in the cultivation of innovative medical talents. For a long time, the teachers in research positions in university affiliated hospitals lack proper development platform and system support. Based on the Six Sigma management method, this project systematically constructed a platform with the DMAIC (Define-Measure-Analysis-Improve-Control) model to encourage the teachers in research positions participating in teaching. As an institutional system, this platform could provide practical reference for the construction of the teachers in research positions in university affiliated hospitals.

本文通过对比研究美、英等发达国家与我国临床医学专业研究生教育质量评价体系的构成及特点,探讨目前我国临床医学专业学位与学术型研究生培养过程中存在的问题,为提高我国临床医学专业研究生的培养质量提供有益参考.

By analyzing the current situation of the quality evaluation system of clinical postgraduate education in China from 1983 to 2017, this paper explores the main problems including the current evaluation object stratification, evaluation content is not comprehensive, evaluation index is not objective and evaluation method is relatively backward. From the practical level of clinical medicine postgraduate training unit, it is proposed that the evaluation subject should be properly adjusted, the evaluation object should be targeted, the evaluation content should be comprehensive and specific, the evaluation index should be objective and standardized, and the evaluation method should keep pace with the times.

Objective:To explore the difficulties and measures of clinical medical postgraduates management during the national prevention of COVID-19 pandemic.Methods:This study mainly used the document review, interview and questionnaire survey methodologies, to investigate the clinical medical postgraduates school situation, online teaching, training, scientific research, psychological state during prevention of COVID-19 emergency.Results:Up to February 14, 2020, the return rate of professional degree postgraduates was 92.8% (256/276). The average score of postgraduates participating in epidemic prevention and control training was 86.59. The effect of online learning was basically the same as that of face-to-face classroom teaching. Up to March 6, 2020, the in-hospital submission rate of postgraduates’ thesis was 50.0% (65/130). Facing the pressures of COVID-19 emergency, 62.6% professional degree postgraduates (124/198) and 35.4% (70/198) academic postgraduates suffered some anxiety or depression, the difference was statistically significant ( P<0.05). Conclusions:During the COVID-19 prevention and control period, it is important to innovate work style, found the linkage system of education department-clinical department-tutor-postgraduates, pay attention to physical and mental health of postgraduates, ensure the quality of teaching, adopt various measures to do well in the education and management of clinical medical postgraduates.

Objective:To investigate the current situation of the guidance of academic graduate students from an affiliated hospital of a university in Beijing, and put forward some suggestions to improve the quality of tutor guidance.Methods:In July 2018, 185 academic graduate students in an affiliated hospital of a university in Beijing were investigated by questionnaire, including 68 master's degree and 117 doctor's degree. The questionnaire includes the basic information of graduate students and tutors, the detailed information of tutors guiding graduate students, and the satisfaction of graduate students with tutors' guidance.Results:The time interval of tutor guidance was one or two weeks, and 65.9%(122/185) of the graduate students received independent tutor guidance, but more graduate students70.3%(130/185)expected to receive tutor guidance in the form of tutor guidance group. There was a statistically significant difference between The time interval of tutor guidance and the number of SCI papers published by graduate students, the sum of influence factors, and the number of SCI papers above Q2( P<0.05). There was a statistically significant difference between the opportunity of academic communication provided by tutor and the number of SCI papers published by graduate students and the sum of IF( P<0.05). Graduate students had a high degree of satisfaction with the tutor's guidance in general, and a relatively low degree of satisfaction with the tutor's opportunity to provide international academic communication. Conclusions:It's very important that strengthen the tutor responsibility system of graduate training, regularly assess the tutor's guidance of graduate students, encourage the joint guidance of graduate students in the form of tutor group; and increase the opportunity of academic communication to promote the improvement of graduate research innovation ability.

目的 调查北京某三甲医院住院医师医患沟通能力并分析其影响因素.方法 2019年9月6日至2019年9月8日通过分层抽样对297名住院医师进行问卷调查,运用医患沟通能力量表(自评)对住院医师医患沟通能力进行评价.结果 被调研住院医师医患沟通能力总分为(3.19±0.67),传递和采集信息能力(3.33±0.64),医患沟通态度及服务能力(3.07±0.73),互动与达成共识能力(3.25±0.62),表达能力(3.22±0.64),确认信息能力(3.16±0.64),体会感受与反馈能力(3.07±0.68).结论 该三甲医院住院医师医患沟通能力整体较好,不同维度与题目之间有一定差异,性别和实习科室数量对沟通能力具有一定影响.

Objective To investigate the attitude of graduates from Peking University Third Hospital towards degree thesis writing and put forward suggestions to improve the quality of degree thesis.Methods This study used interview and questionnaire survey method.Ten graduates from Peking University Third Hospital were interviewed.Difficulties of thesis writing and expected instructions were collected.Then questionnaires were designed based on literature review and the interview results.One hundred and eighty five graduates of Peking University Third Hospital were chosen by stratified sampling and then were surveyed by questionnaires.Results There were 83.8％ (155/185) of graduates,who expressed that degree thesis writing was difficult.Discussion depth,statistical methods and innovation were the most common difficulties in degree thesis writing.There were statistically significant differences in the difficulty of degree thesis writing among different types of degree applicants (F=3.896,P=0.001).Writing skills、writing logic、mining and refining of the results were the most common writing instructions that graduates were expected to receive.Conclusions Most graduates felt difficult in degree thesis writing.Writing difficulties varied from different types of degree applicants.It is necessary to strengthen the target-oriented training and to improve thesis writing in combination with practice.

The training of residents majoring in ultrasound needs not only to pay attention to the teaching of speculative knowledge,but also to "look at pictures and talk",which is based on a large number of diagnostic ultrasound cases,training the residents to find,discover and discriminate the lesions from the ultrasonic images to finally form a sharp recognition and diagnosis ability.This study used the instant messaging tool WeChat to establish a virtual learning platform and implement a case based teaching process through this platform,which can avoid the limitations of time and space,and make the communication between teachers and students faster.According to the questionnaire survey,residents generally believed that the training mode can effectively improve learning efficiency and professional ability and hope to add this training mode to the basis of traditional teaching mode.The results of resident case analysis showed that the diagnostic accuracy of residents gradually increased during the training process.The model of WeChat platform combined with case teaching can provide new ideas and methods for standardized training of resident doctors in ultrasound specialty.

临床教师资格准入制度为保证临床教学质量提供了基本保障,有利于提高临床教师教学能力.通过对我院2012-2016年资格准入结果的分析,发现资格准入通过率的高低与教学学时数成正相关,与科室的教学氛围和教学实力成正相关,强化教师培训对提高准入通过率也有一定的帮助.临床教师资格准入制度有利于医学教育的可持续发展,教师能力的培养应该分个人、科室、医院三个层面实施,相互联系又相互补充;临床教师资格准入只是教学质量保证的制度之一,应与其他制度共同实施.

目的 调查北京市某高校附属医院住院医师医患沟通的现状和对沟通技能培训的需求.方法 采取整群抽样的方法,对227名调查对象进行问卷调查.结果 回收有效问卷205份,有效问卷回收率90.3％.82.4％的调查对象曾有过医患沟通的负面经历,66.8％调整自己后再与患者及家属沟通,有些人的情绪会受到长久的影响,86.5％调查对象的倾诉对象是一起转科的同事,92.2％认为需要开设医患沟通技巧的课程.结论 将医患沟通纳入住院医师必修培训课程体系,提升住院医师医患沟通技能,使之具有良好的职业素养和岗位胜任力.

Objective To explore the effect of doctor-patient communication course on improvement of doctor-patient communication ability of residents.Methods Totally 181residents were chosen as the research object in this self-control study in Peking University Third Hospital,SEGUE framework and questionnaire survey were used to conduct exploratory research at the end of the training of doctor-patient communication on curriculum.Results After the doctor-patient communication skills training,residents in the communication start,information collection,information giving,understand patient and at the end of the interrogation of five modules ability were improved,and the differences are statistically significant (P ＜ 0.001).The residents' satisfaction with the teaching teachers,teaching hours,teaching methods and teaching content was higher.Conclusions In the future,there is need improving the communication start and information collection,enhancing residents' doctor-patient communication ability and building a harmonious relationship between doctors and patients.