基于核心胜任力的检验医学科住培学员终生学习力培养模式研究

A Study on the Cultivation Model of Lifelong Learning Ability for Residents in Laboratory Medicine Based on Core Competency

摘要: 为初步探索基于核心胜任力导向的检验医学科住院医师规范化培训(简称住培)学员终生学习能力培养模式，采用混合研究方法，对右江民族医学院附属医院检验医学科2024年7月至2025年7月在陪的11名住培学员及其带教教师进行调查和访谈，从文献检索、研究设计理解、证据评价、问题识别、诊断分析、决策、医患沟通、团队协作沟通、学术交流、信息获取、信息筛选和自主学习12个能力维度进行评分，每个维度下设5个条目，采用4级评分(1分 = 差，4分 = 非常强)，各维度满分20分。采用方差分析比较不同年级学员各维度能力评分的差异，以决策能力为因变量行单因素线性回归分析；同时，对3名学员代表和2名带教老师进行半结构化访谈，深入探究能力发展的内在机制。研究结果表明，随着培训年级升高，学员的12项能力维度评分均呈现逐年递增趋势(P < 0.05)，11项能力维度评分均对决策能力有显著正向影响(P < 0.05)，其中信息获取能力、证据评价能力和自主学习能力的影响较大。本研究初步提示，检验医学科住培学员的终生学习能力随培训进程逐步提升，多维度能力协同发展对决策能力具有重要促进作用。以核心胜任力为导向，系统化培养学员的自主学习、信息素养与循证思维等能力，可能有助于构建分层递进的终生学习能力培养模式。

Abstract: To preliminarily explore a model for cultivating lifelong learning abilities among residents in the Department of Laboratory Medicine based on core competencies, a mixed-methods was adopted, including quantitative questionnaire survey and semi-structured interviews among 11 residents and their supervising physicians in the Department of Laboratory Medicine at the Affiliated Hospital of Youjiang Medical University for Nationalities who were in training from July 2024 to July 2025. The survey assessed 12 competency dimensions—including literature search, understanding of research design, evidence evaluation, problem identification, diagnostic analysis, decision-making, physician-patient communication, team collaboration and communication, academic exchange, information acquisition, information screening, and self-directed learning. Each dimension comprised five items scored on a 4-point scale (1 = Poor, 4 = Very Strong), with a maximum score of 20 points per dimension. Analysis of variance (ANOVA) was used to compare differences in competency scores for each competency dimension among trainees of different training years, and a univariate linear regression analysis was performed with decision-making ability as the dependent variable. Additionally, semi-structured interviews with 3 representative residents and 2 supervising physicians were conducted to explore the underlying mechanisms of competency development. The results indicate that as trainees progressed through their training years, scores across all 12 competency dimensions showed a year-on-year increase (P < 0.05). Scores in 11 of these dimensions had a significant positive impact on decision-making ability (P < 0.05), with information acquisition, evidence evaluation, and self-directed learning having the greatest influence. These preliminary findings suggest that the lifelong learning competencies of medical laboratory science residents gradually improve as their training progresses, and the synergistic development of these multidimensional competencies plays a significant role in enhancing decision-making ability. Guided by core competencies, a systematic approach may help cultivate residents’ abilities in self-directed learning, information literacy, and evidence-based thinking, thereby potentially establishing a tiered and progressive model for developing lifelong learning competencies.