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住院医师规培 北京协和医院是这样做的

2016-12-22 郭玉卿 健康界

北京协和医院培养出来的住院医师什么样?你是否能跟上他们的节奏?“当颈动脉斑块已成往事”,“我为何如此坐立不安”,问“菌”能有几多愁?是“舌尖上的凶手”,它到底是“魔鬼的翅膀”还是“僵人的苦恼”?“山重水复处,蓦然回首时”,才发现,哦,“原来你还在这里”……如果没有接下来的讲解,你可能怎么也想不到这些有点怪怪的题目背后,是一个个神经科临床病例,并且竟然全都出自住院医之手。他们不光“动手”能力强,脑洞

北京协和医院培养出来的住院医师什么样?你是否能跟上他们的节奏?
“当颈动脉斑块已成往事”,“我为何如此坐立不安”,问“菌”能有几多愁?是“舌尖上的凶手”,它到底是“魔鬼的翅膀”还是“僵人的苦恼”?“山重水复处,蓦然回首时”,才发现,哦,“原来你还在这里”……

如果没有接下来的讲解,你可能怎么也想不到这些有点怪怪的题目背后,是一个个神经科临床病例,并且竟然全都出自住院医之手。他们不光“动手”能力强,脑洞也是一个比一个大!在这种情况下,12月18日,第十一届北京协和医院神经科住院医师病例报告大会召开。

情景再现8分钟
据北京协和医院神经科戴毅介绍,会议主要是为神经科青年住院医师搭建展示临床思维的舞台。在这个舞台上,年轻的住院医们根据亲身经历的临床病例,结合最新研究进展,在8分钟内阐述临床诊疗思路并对所述进行英文总结;来自北京协和医院和其他医院的专家们对台上所述逐个进行提问和点评,并进一步抽丝剥茧,将临床诊治经验分享给大家。

北京协和医院神经科主任崔丽英介绍,作为住院医年终考核的创新形式,经过十年的历练,病例报告大会已经成为一种成熟的临床能力评价方法。评价标准包括:病例内容(20分)、病例分析(20分)、英文表达(5分)、幻灯制作(5分),共计50分。评委会根据评分标准进行现场打分。通过这种形式,住院医们既能展示自己,也能在临床诊疗思路上获得快速提升,受到众多住院医们的欢迎。
北京协和医院神经科主任崔丽英

本次前来“应考”的25名住院医来自4个城市的8家医院,他们均在协和医院完成了或正在进行住院医培训。

临床诊疗这一套
“患者基本信息、现病史、既往史、家族史、入院查体、辅助检查、影像学定位、定性诊断……这一套完整的临床诊疗流程必不可少。”北京协和医院神经科教授杨荫昌认为,在严格遵守这个流程的同时还要注意每一步的先后顺序,“细节决定成败”,如果因为疏忽了哪一步而造成诊断延迟,很有可能给患者的及时救治带来麻烦。
北京协和医院神经科教授杨荫昌

25位参评住院医均做到了这一点,其所述病例不但涉及神经科常见病,还涉及到了罕见病,如北京协和医院神经科韩菲的《不是爱,是伤害》讲述了一例罕见的双侧延髓内侧梗死(MMI)病例;范思远的《变性病?免疫病?相同物质-不同机制》讲述了一例跟中枢神经系统血管炎相近的β-淀粉样脑血管病变相关炎症(CAA)病例;洪月慧的《醒后昏迷的奶奶-且听她“说”》讲述了一例发生在急诊科一位95岁患者身上的抗LGI1脑炎病例,她还就处理急诊发表看法:先急重,后疑难,同时要看到硬币的正反面;基地住院医师吴玉冰的《魔鬼的翅膀》讲述了一例肾上腺脑白质营养不良病例……

循序渐进巧引导
在这些住院医精彩病例的中间,穿插的两个“step by step”更为引人注目。两位协和医院的神经科专家刘明生和关鸿志,分别通过情景模拟以及“协和神经科”微信公众号设置的相关问题来逐步分析病例,并和现场所有医生互动,进行循序渐进的临床诊疗引导。
英文总结不可少
除了上述精彩的病例分析,全场另一大亮点莫过于每个病例后的总结。一直听说协和医院很注重医生英文水平的培养,百闻不如一见。每个病例报告时间虽然只有短短8分钟,但最后都有一个英文总结,流利总结的背后是临床思路清晰的体现。

然而,所有这些都只是冰山一角。

据了解,北京协和医院向来重视住院医师师资培训,并将其作为医学教育领域的重要环节。北京协和医院副院长张抒扬曾指出:“协和医院做好住院医师规培的方式不是亲自培养多少住院医师,而是利用协和传统教学强院的实力、优质的医师队伍和丰富的患者资源,总结一套行之有效的教学管理方法,培养一批精兵强将的教学老师队伍,建立一个医学教育的共享平台,这是协和医院作为中国住院医师培训的开创者和国家首批住院医师规范化培训示范基地,所应肩负的社会责任。”

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    2016-12-24 我是林下之夕

    牛!

    0

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    2016-12-24 saikp
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    2016-12-24 naiwu81

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