摘要
目的了解皮肤科专业基地的骨干师资对皮肤科专科体格检查的认知,为制定皮肤科专科体格检查规范提供依据。方法2021年4月对广东省皮肤科专业基地骨干师资培训班学员对皮肤科专科体格检查的认知,在培训前后采取问卷调查。结果超过70%的骨干师资认为皮肤科专科体格检查和培训非常重要和必要,但约1/3骨干师资没有作为学员或老师参加过皮肤科专科体格检查的任何培训或教学。骨干师资表示现阶段皮肤科住院医师在专科体格检查方面存在体格检查不全面或描述有遗漏和不准确或没有充分触诊等诸多不足,应该加强包括皮肤触诊手法和内容等多方面的培训和考核。皮肤科专科体格检查的范围应包括皮肤及其附属器视触诊、腔口黏膜部位的视诊,其中皮疹的性质、分布和排列、位置、形态等是皮肤病重要的诊断线索。在诊断不清楚、病情复杂、怀疑系统性疾病、病情重的情况下应该选择全身皮肤体格检查。通过培训,骨干师资在全身皮肤体格检查的顺序、皮疹远近视诊、皮疹表面和深部触诊信息的认知方面有了显著的提高(P<0.05)。结论皮肤科住院医师皮肤体格检查的缺陷可能与全身皮肤体格检查的培训和考核不足有关。骨干师资所反馈的信息为制定皮肤科专科体格检查规范提供了依据。全身皮肤体格检查的培训可以帮助住院医师提高对全身皮肤体格检查的认知。
Objective To investigate the cognition of key teachers in speciality bases of dermatology about the professional physical examination and to prepare for the norms of dermatological physical examination.Methods In April 2021,key teachers from speciality bases of dermatology in Guangdong province finished questionnaires about their cognition before and after the training.Results More than 70%of key teachers believed it was very important and necessary for dermatological physical examination and its training,but about 1/3 of them had never been trained or trained as students or teachers.It was pointed out by them that there were many shortcomings in dermatological physical examination in residents of dermatology including incomplete skin examination,missed or incorrect description of skin lesions,insufficient palpation and so on.Training and assessment of many aspects including skills and contents of skin palpation should be fostered.Skin and its appendages,and periorificial mucosa were scope of dermatological examination.The nature,distribution and arrangement,site,configuration of skin rash were important clues for diagnosis of skin diseases.Total skin examination should be performed when the diagnosis was not clear,disease was complex,systemic disease was under suspect,or the disease was severe.Key teachers’cognition about the sequence of total skin examination,gross and close visual examination of skin rash,surface and deep information of skin rash were improved significantly after training(P<0.05).Conclusion Defects in skin examination among dermatological residents might be associated with inadequate training and assessment.Feedbacks from key teachers provide the evidence to formulate the norms of dermatological examination.Training about total skin examination will improve the cognition about total skin examination.
作者
唐旭华
王晔晓
詹济滂
周晖
Tang Xuhua;Wang Yexiao;Zhan Jipang;Zhou Hui(Department of Dermatology,the First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,Guangdong,China)
出处
《中国毕业后医学教育》
2022年第2期131-135,共5页
Chinese Journal of Graduate Medical Education
基金
中山大学本科教学改革项目(31911130-200414,31911130-200434)
关键词
皮肤科
专科体格检查
师资
认知
dermatology
professional physical examination
teachers
cognition
作者简介
通信作者:周晖,E-mail:zhouhongcai@126.com
