目的：探讨督导式教学门诊在眼科住院医师规范化培训中的具体实践和教学效果。方法：通过合理排班、限制号源等措施设立每周固定的督导式教学门诊时间，安排老师和学员出诊；在教学门诊开展4个月后，通过问卷调查和临床技能考核的形式采集反馈意见并评估教学效果。 结果：共有16名老师和8名学员参加了督导式教学门诊，调查问卷结果显示100%的带教老师和学员认可该教学模式，参加过教学门诊的学员临床技能考核得分显著高于对照组(t =3.631， P<0.05)。结论：督导式教学门诊应用于眼科住院医师规范化培训具有实际可行性，并可以提高学员的临床技能水平。

Objective: To explore the application and effects of supervised teaching clinic in standardized training of ophthalmology residents. Methods: A weekly supervised teaching clinic was set through reasonable scheduling and limiting the registration numbers. After 4 months of application, feedbacks were collected through questionnaire survey from both the teachers and residents. Clinical skills assessments were also taken to evaluate the teaching effect. Results: A total of 16 teachers and 8 residents participated in the supervised teaching clinic. The results of the questionnaire showed that 100% of the teachers and residents agreed with the teaching mode. The clinical skill assessment scores of the residents who participated in the teaching clinic were significantly higher than those of the control group (t=3.631, P<0.05). Conclusion: The application of supervised teaching clinic in standardized training of ophthalmology residents is feasible and can improve the clinical skills of the residents. 

目的：探讨眼科临床指南结合团队式学习(team-based learning,TBL)教学课程在眼科住院医师规范化培训中的应用及教学效果。方法：本研究选取2022年1月—2023年6月在广州医科大学附属第一医院眼科进行住院医师规范化培训的15名住院医师作为研究对象，先后交替使用自学讲课、TBL教学这两种教学模式进行眼科临床指南学习，通过填写满意度调查问卷及评估出科考通过率、学业水平测试成绩、结业考通过率，从主观及客观角度探讨临床指南结合TBL学习模式的教学效果。结果：住院医师对增加眼科临床指南学习具有较高评价，且不认为会增加其学习负担。开展指南学习后，住院医师出科考试及格率、学业水平测试通过率、结业考通过率均为100%。在培养团队合作能力、改善学习氛围两方面，TBL讲课的满意度均高于自学讲课(均P＜0.001)。93.3%(14/15)的住院医师更喜欢TBL教学模式。结论：眼科临床指南结合TBL教学是一种有效的教学模式，住院医师在主观满意度调查问卷及客观考试成绩的评估中，均达到满意的教学效果。

Objective: To investigate the application and teaching effect of clinical guidelines combined with team based learning(TBL) teaching courses in standardized training for ophthalmic residents. Methods: 15 residents who received standardized training in the ophthalmology department of the First Affiliated Hospital of Guangzhou Medical University were recruited from January 2022 to June 2023. Self-study teaching and TBL teaching were successively applied to teach the clinical guidelines of ophthalmology. The subjective and objective teaching effects were evaluated by satisfaction questionnaire, passing rate of phase examination, achievement of academic proficiency test and passing rate of final examination. Results: The clinical guidelines enjoy the high opinion in the residents, and would not be strengthen their learning burden. After the residents studied clinical guidelines, their passing rate of the phase exam, academic proficiency test and final examination were all 100%. In terms of cultivating teamwork ability and study atmosphere, the satisfaction of TBL lectures was significantly higher than that of self-study lectures (P< 0.001). 93.3% (14/15) of the residents preferred TBL lectures. Conclusions: The combination of ophthalmology clinical guidelines and TBL teaching was proved to be an effective teaching model. The residents achieved excellent teaching results in the subjective satisfaction questionnaire and objective examination scores.

目的：探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题，以期改进培训方式。方法：以2020年4月在中山大学中山眼科中心培训的154名学员为对象，进行问卷调查，采用SPSS 20.0统计学软件进行数据分析。结果：共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%；住培则显著高于前者，分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断，90.8%的专硕选择了临床诊断(P=0.007)，94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001)；而住培仅为去除囊壁(P<0.001)。结论：睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高，并根据各类型学员的临床能力和认知差异，进行分级分类培训。

Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.

眼科住院医师规范化培训(以下简称“规培”)是培养眼科医师的必要环节。我国规培模式日臻成熟，但眼科规培过程管理中仍存在诸多问题，包括专科医院和综合医院的规培协调问题、师资激励、规培学员类型多样、研究生和规培“双轨制”、如何开展显微手术技能培训等，很多具体方案和措施仍在摸索中。眼科专科医院学科体系建设相对完善，配备更充足的教学资源，有一定的规培经验，是眼科规培的主力军。汕头国际眼科中心结合国家要求创建了一套规培模式，注重规范化、标准化和个性化相结合，并通过借鉴香港及海外住院医师培训经验，丰富理论培训形式，优化操作培训环境，突出外语和科研能力训练，强调系统性临床思维。本文基于汕头国际眼科中心五年来开展眼科规培的实践经验与思考，总结当前眼科专科医院规培现状，并提出对策和建议。

Standardized training for ophthalmology residents is an essential stage during the development of ophthalmologists. The standardized training system has become more and more mature, while problems still exist in the aspects of coordination between specialized hospitals and general hospitals, teacher resources, unevenness of trainees, combination of postgraduate education and residency standardized training, microsurgical skills training, and so on. Therefore, programs and strategies of standardized training are still under exploration. Eye hospitals, with the excellent disciplinary system, adequate resources, and advanced experience, play a key role in standardized training for ophthalmology residents. Joint Shantou International Eye Center has set up a training model in accordance with national requirements, focusing on the combination of standardization, normalization, and individuation. Besides, by learning from the oversea experience of residents training, Joint Shantou International Eye Center has enriched the training forms, optimized the skill training environment, and highlighted the training of foreign language, scientific research, and systematic clinical thinking. This paper, based on the 5-year experience and reflection on standardized training for ophthalmology residents in Joint Shantou International Eye Center, summarizes the current status of standardized training and put forward some measures and suggestions.

目的：探索翻转课堂联合改良的迷你临床演练评估(mini-clinical evaluation exercise，Mini-CEX)在眼科住院医师规范化培训中的应用可行性及效果。方法：回顾性分析上海交通大学医学院附属第九人民医院眼科在2018—2021年所有参加规范化培训结业考核的住院医师，共计39人。比较翻转课堂教学方法实施前后，包括改良Mini-CEX在内的综合能力考核、毕业合格率、课程出勤率及学员对教学模式的满意度。结果：实验组20人(2020及2021年毕业)，对照组19人(2018及2019年毕业)。两组间的性别比例、学历或学制构成差异无统计学意义(P>0.05)。实验组的毕业合格率明显高于对照组(100.00% vs 68.42%，P=0.008)；改良Mini-CEX(P=0.011)及放射诊断(P=0.025)平均成绩也显著高于对照组。两组的理论考核及心电图诊断的平均成绩无统计学差异。4年间的比较发现，学员的改良Mini-CEX平均成绩(P=0.006)及线下课出勤率(P=0.025)出现显著提升。实验组对教学模式的满意度显著高于对照组。结论：翻转课堂联合改良Mini-CEX应用于眼科住院医师规范化培训教学可获得良好效果，提示了积极的深入研究及拓展应用前景。

Objective: To evaluate the application of flipped classroom combined with revised mini-clinical evaluation exercise (Mini-CEX) in standardized training for ophthalmology residents. Methods: A retrospective analysis was performed on 39 residents who participated in the standardized training graduation examination during 2018 to 2021 in ophthalmology department of Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The comprehensive ability assessment including the improved Mini-CEX, pass rate of program completion, course attendance rate, and students’ satisfaction with the teaching mode were compared before and after the implementation of the flipped classroom teaching method. Results: There are no significant difference of sex or educational level was found between the experimental group (20 people graduated in year 2020 and 2021) and the control group (19 people graduated in year 2018 and 2019). Compared with the controls, the pass rate (100.00% vs 68.42%, P=0.008) and the average scores of revised Mini-CEX (P=0.011) and radiology (P=0.025) were significantly higher in the experimental group, while the average scores of basics and electrocardiograph were almost the same. Among the 4 years, the average revised Mini-CEX scores (P=0.006) and attendance rate of off-line courses (P=0.025) significantly progressed. Surveys of satisfaction degree suggested that the experimental group were significantly more satisfied with the education they accepted during their residency training program. Conclusion: It is effective to apply flipped classroom combined with revised Mini-CEX in residency training program of ophthalmology. Further study and development on this teaching pattern is encouraged.

目的：探讨基于微信的图像存储和传输系统(picture archiving and communication system，PACS)教学在眼眶科规培医生中的教学效果及质量评价。方法：将中山眼科中心眼眶科轮训的66名规培医生分为A组(PACS组)与B组(微信+PACS组)。通过出科考核和问卷分析比较两组学生的教学效果及满意度。结果：B组学生的基础知识测试和阅片技能测试得分均显著高于A组(P<0.001，P=0.037)。教学效果自我评估量表显示B组学生对解剖结构位置的熟悉程度、影像学诊断、鉴别诊断能力、工作中解读CT或MRI图像的能力预判，以及对CT或MRI影像学的兴趣，明显优于A组(均P<0.001)。所有学生(100.00%)对这种教学模式感到非常满意。结论：在眼眶科住院医师规划化培训中应用基于微信的PACS教学模式能显著提高教学效果和满意度，提高教学质量。

Objective: To evaluate the application quality of picture archiving and communication system (PACS) based on WeChat in standardized resident training in orbital department. Methods: A total of 66 doctors trained in the Orbital Department of Zhongshan Ophthalmic Center were divided into group A (PACS group) and Group B (WeChat +PACS group). The quality and feedback of teaching of the two groups of students were compared through examination and questionnaire. Results: The scores of basic knowledges and reading skills of group B were significantly higher than those of group A (P<0.001, P=0.037). The self-assessment scale for teaching quality showed that the students in group B were superior to group A in understanding the position of anatomical structure, imaging diagnosis and differential diagnosis according to CT or MRI, interpreting CT or MRI images in the future, and interest in CT or MRI imaging (all P<0.001). All the students (100.00%) were very satisfied with this mode of teaching. Conclusion: The application of PACS based on WeChat in standardized resident training in orbital department can significantly improve the quality and satisfaction of ophthalmology teaching.

住院医师规范化培训(简称“住培”)是我国新医改的一项重要举措，旨在通过住培来使我国临床 整体医疗水平同质化提高，解决民众日益增长的医疗需求和各地医疗发展不平衡之间的矛盾。我 国眼科住培改革经历十余年，在追求同质化的实践中发现一些值得重视的问题，如教学师资的选 拔和培训、临床操作类教学的落实、教学师资待遇的提升以及包括人文在内的住院医师诊疗能力 全面培养等。本文探讨了这些问题的根源和解决方法，希望通过改革将住培这一临床医学基础工 程更好的落到实处。

Standardized resident training (called ‘ZhuPei’ for short in Chinese) is an important measure of the New Healthcare Reform in China, aiming to promote the homogenization of clinical medicine level which tackles the constraints of unbalanced medical development so that people’s ever-growing medical demand can be supplied. With the reality of over 10 years’ ophthalmology standardized resident training experience in China, certain crucial issues are put forward, such as the selection and training of teachers, the implementation of clinical training course, the concern of teachers’ salary and promotion, the residents’ capabilities of diagnosis and treatment including humanistic care, etc. This article discusses the root causes of those issues and the solutions to them, intending to implement the standardized resident training as a basic clinic medical engineering through the New Healthcare Reform