质量导向的住院医师规范化培训全程覆盖督导体系构建与实践

周庆; 唐东; 王云云; 倪狄荣; 朱雨秋; 潘玲玲; 陈丽; 杨晓清

doi:10.3760/cma.j.cn116021-20260105-02281

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质量导向的住院医师规范化培训全程覆盖督导体系构建与实践

更新时间：2026-07-01

- 质量导向的住院医师规范化培训全程覆盖督导体系构建与实践
- Construction and practice of a quality-oriented, whole-process supervision system for standardized residency training
- 中华医学教育探索杂志 2026年页码：1-6
- 作者机构：
  
  1.南通大学附属医院教育培训处，南通 226001
  2.南通大学附属医院妇产科，南通 226001
- 作者简介：
  
  杨晓清，Email：ntyxq169@126.com
- 基金信息：
  
  江苏高校“青蓝工程”资助项目(2023)
- DOI：10.3760/cma.j.cn116021-20260105-02281
  中图分类号： R-05
- 收稿：2026-01-05，
  
  网络首发：2026-05-20，
- 稿件说明：
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周庆, 唐东, 王云云, 等. 质量导向的住院医师规范化培训全程覆盖督导体系构建与实践[J/OL]. 中华医学教育探索杂志, 2026,1-6.

Zhou Qing, Tang Dong, Wang Yunyun, et al. Construction and practice of a quality-oriented, whole-process supervision system for standardized residency training[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-6.
周庆, 唐东, 王云云, 等. 质量导向的住院医师规范化培训全程覆盖督导体系构建与实践[J/OL]. 中华医学教育探索杂志, 2026,1-6. DOI： 10.3760/cma.j.cn116021-20260105-02281.

Zhou Qing, Tang Dong, Wang Yunyun, et al. Construction and practice of a quality-oriented, whole-process supervision system for standardized residency training[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-6. DOI： 10.3760/cma.j.cn116021-20260105-02281.

摘要

分析当前住院医师规范化培训督导工作中存在的督导理念认知偏差、系统化督导机制缺失、重“督”轻“导”、结果应用与绩效关联性弱等制约督导质量效能的突出问题。基于全面质量管理理论，构建并实践了“质量导向、点面融合、全程覆盖、绩效关联、持续改进”的系统化住培督导体系。通过采取一系列举措，包括对督导专家与教学主任进行督导能力系统化分层培训、建立“专家重点督导”与“教学主任交叉督导”双轨覆盖机制、强化督导结果与多方绩效考核挂钩、构建定期反馈与数据驱动的改进闭环管理等，实现了月度教学活动督导全覆盖（100.0%）。学员培养质量明显提升，出科考试首考通过率从84.5%提高到98.0%，学生培训满意度从82.7%提升至98.0%，教学活动规范率从75.0%上升至95.0%。90.0%的受访带教教师认为督导有助于改进教学规范、提升教学质量，督导整改完成率达100.0%，取得了培训质量显著提升的良好成效，有效破解了督导碎片化、形式化难题，为住培内涵建设提供了可操作的质量监控与改进框架。

Abstract

This study analyzes the prominent issues constraining the quality and effectiveness of supervision in standardized residency training

including cognitive deviations in the understanding of supervision concepts

the absence of a systematic supervision mechanism

an overemphasis on "inspection" at the expense of "guidance"

and a weak correlation between the application of supervision results and performance evaluation. Based on the theory of total quality management

a systematic supervision system for standardized residency training

characterized by quality orientation

integration of focal and comprehensive aspects

full-process coverage

performance linkage

and continuous improvement

was developed and implemented. Through a series of measures

including systematic and tiered training to enhance the supervisory capabilities of supervision experts and teaching directors

the establishment of a dual-track coverage mechanism combining expert-led targeted supervision and cross-supervision by teaching directors

strengthening the linkage between supervision results and multi-faceted performance evaluations

and constructing a closed-loop improvement management system driven by regular feedback and data

complete supervision coverage (100.0%) of monthly teaching activities was achieved. The quality of resident training was significantly improved

with the first-attempt pass rate for end-of-rotation examinations increasing from 84.5% to 98.0%

trainee satisfaction from 82.7% to 98.0%

and the standardization rate of teaching activities from 75.0% to 95.0%. Among the interviewed instructors

90.0% acknowledged that supervision helped improve teaching standardization and enhance teaching quality

and the completion rate for corrective actions based on supervision feedback reached 100.0%. These results demonstrate a substantial enhancement in training quality

effectively addressing the challenges of fragmented and superficial supervision

and providing an operational framework for quality monitoring and improvement that supports the substantive development of standardized residency training.

关键词

Keywords

references

刘超，刘昌，种铁，等 . 住院医师规范化培训督导体系探索与实践 [J ] . 中国毕业后医学教育， 2025 ， 9 （ 3 ）： 202 - 205 . DOI: 10.3969/j.issn.2096-4293.2025.03.010 http://dx.doi.org/10.3969/j.issn.2096-4293.2025.03.010 .

石羽茜，邹思敏，朱丹彤，等 . 住院医师规范化培训院科两级督导体系的实践与优化 [J ] . 中国毕业后医学教育， 2025 ， 9 （ 1 ）： 1 - 4 . DOI: 10.3969/j.issn.2096-4293.2025.01.001 http://dx.doi.org/10.3969/j.issn.2096-4293.2025.01.001 .

陈颖，李越，王亚军，等 . 基于提升质量内涵建设的住培教学督导实践探索 [J ] . 中国毕业后医学教育， 2024 ， 8 （ 5 ）： 325 - 328 . DOI: 10.3969/j.issn.2096-4293.2024.05.002 http://dx.doi.org/10.3969/j.issn.2096-4293.2024.05.002 .

金明珠，严梦玲，范让，等 . 住院医师规范化培训督导反馈体系的建立与应用 [J ] . 中华医学教育杂志， 2025 ， 45 （ 8 ）： 571 - 576 . DOI: 10.3760/cma.j.cn115259-20240627-00668 http://dx.doi.org/10.3760/cma.j.cn115259-20240627-00668 .

中国医师协会 . 中国医师协会关于印发住培内容与标准、基地标准（2022年版）的通知 [EB/OL ] .（ 2022-08-05 ）[ 2026-03-23 ] . https://www.ccgme-cmda.cn/news/15117/article https://www.ccgme-cmda.cn/news/15117/article .

余京飞，穆攀伟，陈璐，等 . 基于成人学习理论的住院医师规范化培训院级督导专家培训项目及其效果分析 [J ] . 中华医学教育探索杂志， 2025 ， 24 （ 2 ）： 277 - 282 . DOI: 10.3760/cma.j.cn116021-20240627-01951 http://dx.doi.org/10.3760/cma.j.cn116021-20240627-01951 .

ACGME . ACGME common program requirements（Residency） [EB/OL ] . （ 2025-09-03 ）[ 2026-03-23 ] . https://www.acgme.org/globalassets/pfassets/programrequirements/2026-prs/cprresidency_2026_feb_revision.pdf https://www.acgme.org/globalassets/pfassets/programrequirements/2026-prs/cprresidency_2026_feb_revision.pdf .

General Medical Council . Promoting excellence: standards for medical education and training [EB/OL ] . （ 2015-07-15 ）[2026- 03 - 23 ] . https://www.gmc-uk.org/cdn/documents/promoting-excellence-standards-for-medical-education-and-training-2109_pdf-61939165.pdf https://www.gmc-uk.org/cdn/documents/promoting-excellence-standards-for-medical-education-and-training-2109_pdf-61939165.pdf .

段茗玉，陈燕敏，李惠明，等 . 高校附属医院后备教学督导专家梯队构建及胜任力提升实践研究 [J ] . 中华医学教育探索杂志， 2025 ， 24 （ 8 ）： 1045 - 1050 . DOI: 10.3760/cma.j.cn116021-20250201-02100 http://dx.doi.org/10.3760/cma.j.cn116021-20250201-02100 .

高虹霞 . 住院医师规范化全纬度督导体系的构建和应用研究 [J ] . 中国医学教育技术， 2020 ， 34 （ 1 ）： 89 - 92 . DOI: 10.13566/j.cnki.cmet.cn61-1317/g4.202001021 http://dx.doi.org/10.13566/j.cnki.cmet.cn61-1317/g4.202001021 .

张爱武，姜涛，符元证，等 . 细化教学查房评分量表对提升教学查房督导评分一致性的作用研究 [J ] . 中国毕业后医学教育， 2025 ， 9 （ 11 ）： 815 - 819 . DOI: 10.3969/j.issn.2096-4293.2025.11.004 http://dx.doi.org/10.3969/j.issn.2096-4293.2025.11.004 .

周庆，唐东，吉云兰，等 . 分层递进教学在住院医师规范化培训中的应用难点与对策思考 [J ] . 中华医学教育探索杂志， 2024 ， 23 （ 8 ）： 1118 - 1122 . DOI: 10.3760/cma.j.cn116021-20231022-01735 http://dx.doi.org/10.3760/cma.j.cn116021-20231022-01735 .

朱亚琴，康宝丽，罗茜，等 . 住院医师规范化培训教学督导信息化建设的实践研究 [J ] . 中华医学教育探索杂志， 2024 ， 23 （ 8 ）： 1134 - 1138 . DOI: 10.3760/cma.j.cn116021-20230503-01723 http://dx.doi.org/10.3760/cma.j.cn116021-20230503-01723 .

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