According to the current relationship between doctors and patients and the present situation of postgraduate training of medical master's degree, it is suggested to improve the humanistic medical quality of postgraduate students of medical master's degree by strengthening the education of practical skills of humanistic medicine, promoting the close combination of humanistic medical quality training and clinical practice, and establishing an evaluation system for humanistic medical quality training.
Keywords: humanistic medical quality; Clinical medicine; Master
Different from other graduate students and residents who work directly after graduation, graduate students with a master's degree in medicine can complete postgraduate study and standardized training for residents within three years. Combined with the construction of standardized training system for residents in China, we will carry out the pilot reform of postgraduate training mode for medical master's degree, and explore the talent training mode (also known as combined mode) that organically combines postgraduate education for medical master's degree with standardized training for residents [1]. Humanistic medical quality training is a subject worthy of attention and discussion in the integration mode, which is of great significance for cultivating advanced applied medical talents with strong clinical practice ability, good clinical application ability, good academic qualifications and qualified clinical practice qualifications within three years.
1 The requirements of merging mode for improving the quality of graduate students.
1. 1 Strengthen the cultivation of clinical practice ability and require graduate students to stick to the clinical front line.
20 13 12 3 1, seven ministries and commissions in the State Council jointly issued the Guiding Opinions on Establishing a National Standardized Training System for Residents, proposing to establish a National Standardized Training System for Residents, requiring that all clinicians with bachelor degree or above in new medical posts receive standardized training for residents by 2020. Standardized training of residents is the only way for clinicians to grow up. Establishing a standardized training system for residents is a major basic project to strengthen the construction of clinicians, a major measure to deepen medical reform and medical education reform, and a fundamental strategy to improve the quality and level of medical services. Postgraduates with a master's degree in medicine become residents at the same time. During school, you need to take and pass the qualification examination and registration of medical practitioners, as well as the theoretical examination and practical examination of standardized training for residents. Becoming a resident means really contacting patients, experiencing the whole process of doctor-patient communication and entering the practical stage of doctor-patient communication. On the one hand, residents are front-line doctors in hospitals, who have more contact with patients, longer contact time and heavier workload; On the other hand, because I entered the hospital for the first time, I also had a process of adapting to the hospital environment and running in with all parties. Therefore, there is an urgent need for training and guidance in medical ethics, medical policies and regulations, clinical practice skills, professional theoretical knowledge and interpersonal communication.
1.2 Strengthen the cultivation of scientific research ability and require graduate students to ensure their academic level.
While receiving strict standardized training for residents, graduate students need to master cutting-edge medical theoretical knowledge and scientific clinical thinking methods through face-to-face teaching, online teaching and self-study, master the' basic methods' of clinical research, complete and publish master's degree dissertations, and defend their dissertations to improve the scientific research level.
1.3 Cultivating high-level applied medical talents requires graduate students to have good humanistic medical quality.
How to form a good professional ethics, cultivate a correct academic atmosphere and build a harmonious doctor-patient relationship in the busy front-line clinical work, high-level academic research and the learning rhythm of three years and four certificates is a subject that needs further study in the integrated mode of postgraduate training of medical master's degree and standardized resident training [2]. The standardized training of residents clearly stipulates that comprehensive medical literacy training including interpersonal communication, such as medical ethics, clinical practice skills, professional theoretical knowledge and medical policies and regulations, will not shake the foundation of medical humanities education. Humanistic medical practice skills are important skills for doctors to practice [3]. Internationally, medical practitioners are required to have not only medical professional knowledge and skills, but also practical skills in humanities medicine. In order to become a medical practitioner abroad, the cultivation of humanistic medical practical skills is one of the compulsory courses. According to the Opinions of the Ministry of Health on Strengthening the Style Construction of Health Industry, the Medical Ethics Standards and Implementation Measures for Medical Staff and the General Principles of Standardized Training Standards for Specialist/Resident, the Chinese Medical Doctor Association has formulated a training system for humanistic medical practice skills, aiming at improving doctors' humanistic medical practice skills through training and quantitative assessment.
2. The cultivation of humanistic medical quality of medical students is not synchronized with clinical practice.
2. 1 Theoretical study and clinical practice are not synchronized in undergraduate education.
Most medical colleges and universities offer doctor-patient communication courses, including theoretical courses and probation courses, which cover medical norms, medical regulations, communication skills between doctors and patients, basic methods to deal with disputes between doctors and patients, consultation, illness description, preoperative conversation and so on. Judging from the medical education practice and students' feedback in recent years, the cases told in the theoretical course of doctor-patient communication or the trainee course all come from clinical practice, but the students have no direct contact with clinical work and lack the experience of direct communication with patients, so the clinical scenes told in the intercom class are unfamiliar, which makes the teaching effect of the doctor-patient communication course not fully reflected. Students can communicate with doctors and patients after entering clinical practice, but there is no relevant teaching content in the clinical practice stage.
2.2 Postgraduate education lacks specialized humanities and medical skills training.
In the postgraduate education stage, courses such as clinical comprehensive quality training and clinical general skills training are offered, but there is no special humanistic medical skills training course. Postgraduates with a master's degree in medicine become residents and begin to serve patients at the same time, so humanistic medical quality is essential [4]. Good doctors cure diseases, good doctors cure diseases. A professional and profound doctor does not necessarily have scientific values, professional service attitude, interpersonal communication ability, medical work management ability, teamwork spirit and psychological adaptability. These abilities are not only related to the personal development of doctors, but also to the therapeutic effect of patients and the virtuous circle of doctor-patient relationship. At present, there are many reasons for the tension between doctors and patients, among which the lack of humanistic quality of medical staff is one of the important factors.
Three methods of cultivating humanistic medical quality
3. 1 Improve the practical skills of humanistic medicine
Humanized medical practice skill training system is applied to standardized training of residents. Through social investigation (outpatient, ward, community), case analysis, role-playing, standardized patient teaching (SP teaching) and outpatient (bedside) teaching, residents are systematically trained in how to establish a good doctor-patient relationship with patients and their families, how to reach a consistent treatment plan with patients, how to better resolve the contradiction between doctors and patients, and how to tell patients bad news.
3.2 Humanistic medical quality training and clinical practice synchronization
Cultivating humanistic medical quality in clinical practice and repeated training from theory to practice are helpful to improve the humanistic medical quality of residents [5]. To investigate the actual situation of doctor-patient communication within two months after residency, such as "you and me in doctor-patient communication", "doctor-patient communication in my eyes" and "joys and worries in doctor-patient communication I met". And hand over the collected cases to the teaching teacher, who will analyze and comment on the cases during the "small lecture on humanistic medical quality training" and carry out targeted humanistic medical practice skills training. Residents apply the skills they have learned to the next stage of clinical practice to test the learning effect [6], and train every two months 1 time, for a total of 12 months. After many cycles, residents' communication ability between doctors and patients and humanistic medical quality have been continuously improved, medical disputes have been reduced, and the harmonious development of doctor-patient relationship has been promoted.
3.3 the establishment of humanistic medical quality training evaluation system
In view of the importance of doctor-patient communication skills to improve the doctor-patient relationship, medical educators attach great importance to the evaluation of doctor-patient communication skills [7]. SEGUE scale was used to evaluate the training results after pre-job training, working for 6 months and working for 12 months. SEGUE scale's evaluation of residents' communication ability includes the following contents: attitude (self-perceived attitude, awareness of the importance of skills), knowledge, skills (interview skills, communication skills, bad news skills) and literacy (occupational stress, sympathy). The national standardized training system for residents is a fundamental solution to improve the quality of doctors in China, which lays the foundation for the professional development of residents and is of great significance to improve the medical level in China. The mode of combining postgraduate training of medical master's degree with standardized resident training is an inevitable requirement for the training of advanced medical talents at present. In order to cultivate qualified doctors with high academic qualifications and high quality, it is necessary to cultivate humanistic medical quality throughout the training, strengthen the training of humanistic medical practical skills, improve the communication ability between doctors and patients, lay the foundation for the sustainable development of residents and build a harmonious doctor-patient relationship.
References:
[1] Wang Ling. Exploration and innovation of comprehensive reform of degree education in clinical medicine [J]. Degree and postgraduate education, 2012 (10):12-13.
[2] Ma,,, Zhang. On the cultivation of doctor-patient communication quality of graduate students [J]. Health Vocational Education, 20 10/0,28 (12):132-133.
[3] Cao Yongfu, Zhang, Yang Tongwei. On doctors' humanistic practical ability and its cultivation [J]. Medicine and Philosophy, 2009,30 (6): 9-12.
[4] Wang. Doctor-patient communication [M]. Beijing: People's Health Publishing House, 2006.
[5] Curved waves. Strengthening humanistic quality education and training qualified medical talents in the new century [J]. China Journal of Hospital Management, 2007,23 (2): 98-100.
[6] Geng Baqun. Reflections on medical humanities education in health vocational education [J]. Health Vocational Education, 2009,27 (12):19-20.
[7]AmmentorpJ，MainzJ，SabroeS。 Communication health care [j]. ugesklmger, 2006( 168):3437-3440.
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