Application of a tiered-categorized-integrated training model in standardized neurology residency training

Pan Yuanmei; Yao Xiaoying; Feng Zhiying; Dai Ruolian; Wang Gang

doi:10.3760/cma.j.cn116021-20250410-02135

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Application of a tiered-categorized-integrated training model in standardized neurology residency training

Standardized Residency Training | 更新时间：2025-10-29

- Application of a tiered-categorized-integrated training model in standardized neurology residency training
- Chinese Journal of Medical Education Research Vol. 24, Issue 10, Pages: 1365-1371(2025)
- 作者机构：
  
  上海交通大学医学院附属仁济医院神经内科，上海 200127
- 作者简介：
  
  Wang Gang, Email: wanggang@renji.com
- 基金信息：
  
  High-Level Local University Construction Project of Shanghai Jiao Tong University School of Medicine—Cultivation of Excellent Innovative Medical Talents(BYH20240402)
- DOI：10.3760/cma.j.cn116021-20250410-02135
  CLC： R-4
- Received：10 April 2025，
  
  Published：20 October 2025
- 稿件说明：
移动端阅览
潘元美, 姚小英, 冯智英, 等. 分层分类一体化培训模式在神经内科专业基地规范化培训中的应用研究[J]. 中华医学教育探索杂志, 2025, 24(10): 1365-1371.

Pan Yuanmei, Yao Xiaoying, Feng Zhiying, et al. Application of a tiered-categorized-integrated training model in standardized neurology residency training[J]. Chinese journal of medical education research, 2025, 24(10): 1365-1371.
潘元美, 姚小英, 冯智英, 等. 分层分类一体化培训模式在神经内科专业基地规范化培训中的应用研究[J]. 中华医学教育探索杂志, 2025, 24(10): 1365-1371. DOI： 10.3760/cma.j.cn116021-20250410-02135.

Pan Yuanmei, Yao Xiaoying, Feng Zhiying, et al. Application of a tiered-categorized-integrated training model in standardized neurology residency training[J]. Chinese journal of medical education research, 2025, 24(10): 1365-1371. DOI： 10.3760/cma.j.cn116021-20250410-02135.

摘要

目的

探讨分层分类一体化培训模式在神经内科专业住院医师规范化培训中的应用效果。

方法

采用前后对照研究，选取2023年1月至2024年6月在上海交通大学医学院附属仁济医院神经内科轮转的住院医师109人为研究对象，2023年1月至2023年7月的43人为对照组，采用传统培训模式；2023年8月至2024年6月的66人为观察组，采用分层分类一体化培训模式，以胜任力为导向，先将住院医师分类为“神经内科专业”和“非神经内科专业”，再基于能力框架进行分层递进，从师资配备、培训活动、考核评估等方面进行系统性优化与资源整合。通过对半年度考核（神经内科专业）、日常考核和出科考核（非神经内科专业）以及360评估进行效果评价。采用SPSS 26.0进行卡方检验和

检验。

结果

观察组的非神经内科专业住院医师在出科总评分[（90.93±4.21） vs. （86.08±8.98），

=0.004

]

、理论考试[（16.47±2.47） vs. （13.55±5.34），

=0.003

]

、临床操作[（9.32±0.47） vs.（9.00±0.58），

=0.004

]

及病例分析[（86.75 ±5.95） vs. （82.64±11.20），

=0.047

]

方面优于对照组（

0.05）。神经内科专业住院医师在体格检查成绩上优于对照组[（87.50±8.66）vs.（75.00±8.17），

=0.040

]

。且在360度评估中，观察组在专业能力、病人管理、职业素养及沟通合作等核心胜任力的部分评估指标表现更优（

0.05）。

结论

分层分类一体化培训模式有助于住院医师在轮转科室更高效地掌握基本知识和技能，同时提升其专业能力、病人管理及沟通合作等核心胜任力，该模式为临床轮转科室在有限资源下实现高效、精准的培训管理提供了可复制的实践方案。

Abstract

Objective

To explore the effects of a tiered-categorized-integrated training model in standardized neurology residency training.

Methods

This controlled before-and-after study enrolled 109 residents who rotated in the Department of Neurology of Renji Hospital of Shanghai Jiao Tong University School of Medicine from January 2023 to June 2024. Among them

43 residents from January to July 2023 were assigned to control group to receive the traditional training model

while 66 residents from August 2023 to June 2024 were assigned to observation group to follow the competency-oriented tiered-categorized-integrated training protocol. In the observation group

the residents were categorized into neurology specialty and non-neurology specialty groups to follow a competency-based hierarchical and progressive training approach with systematical optimization and resource integration in

terms of faculty allocation

training activities

and assessment evaluations. The effectiveness of the models was evaluated through semi-annual assessments (for neurology specialty)

routine assessments and end-of-rotation assessments (for non-neurology specialty)

and 360-degree evaluations. SPSS 26.0 was used to perform chi-square tests and

-tests.

Results

The non-neurology specialty residents in the observation group significantly outperformed the control group in the total score of end-of-rotation assessments [(90.93±4.21) vs. (86.08±8.98)

=0.004

]

theoretical examinations [(16.47±2.47) vs. (13.55±5.34)

=0.003

]

clinical skills [(9.32±0.47) vs. (9.00±0.58)

=0.004

]

and case analysis [(86.75±5.95) vs. (82.64±11.20)

=0.047

]

. The neurology specialty residents in the observation group showed a significantly higher physical examination score than the control group [(87.50±8.66) vs. (75.00±8.17)

=0.040

]

. Furthermore

in the 360-degree evaluation

the observation group exhibited better performance in certain assessment indicators of core competencies

including professional ability

patient management

professionalism

and communication and cooperation (

0.05).

Conclusions

The tiered-categorized-integrated training model helps residents to better grasp basic knowledge and skills in rotations

and also enhances their core competencies such as professional ability

patient management

and communication and cooperation. This model provides a replicable practical solution for clinical departments to achieve efficient and precise rotation management within the constraints of limited resources.

关键词

Keywords

references

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