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目的 调查青年医师参与临床教学工作的感受及其教学能力培训情况,了解他们所面临的困难及需要的帮助.方法 选择437名在北京大学第一医院工作的主治医师和正在接受住院医师规范化培训(含第二阶段)的住院医师为调查对象,分为主治医师组和住院医师组.采用问卷调查方法,了解他们参加临床教学工作的动机和感受,接受教学培训情况,从事教学工作的困难和需要的帮助.比较住院医师和主治医师两组间存在的差异,采用多因素逻辑回归方法,分析造成被调查者集中反映的内心感受、困难体验及帮助需求等现象的主要影响因素.结果 发放调查问卷440份,收回有效问卷437份,有效问卷回收率99.3％.实际抽样调查比例,主治医师组为66.3％,住院医师组为61.1％.在437名被调查者中,84.7％的人员直接参与了临床教学工作;认为自己属于被动参与临床教学工作的人员占比55.6％;主治医师组直接参与临床教学工作和被动参与临床教学工作的比例均显著高于住院医师组(P＜0.05).喜欢从事临床教学工作的人员占比67.7％;认为从事教学工作有益于自身学习进步的人占比90.4％;提出接受系统教学能力培训需求的人员占比50.3％;在这些项目的认同比例上,主治医师组与住院医师组之间的差异无统计学意义.主治医师组接受过教学培训的人员比例显著高于住院医师组(P＜0.05).“认为自身知识、教学能力欠缺,不足以支撑教学工作”的困难体验,在住院医师组中的发生率显著高于主治医师组(P＜0.05).多因素Logistic Regression分析结果显示,直接参与教学活动(OR:2.733,P=0.001)、以提高自身能力为动机参与教学(OR:5.677,P=0.000)和因为热衷于培养年轻医生而参与教学工作(OR:4.752,P=0.000)是产生“喜欢从事教学工作”心理感受的主要影响因素.工作或受训年限(OR:0.752,P=0.003)、学历(OR:0.581,P=0.001)、参与教学活动的动机,“提高自身能力”(OR:1.833,P=0.005)、“热衷于培养年轻医生”(OR:1.863,P=0.026)是产生“认为自身知识、教学能力欠缺,不足以支撑教学工作”这一困难体验的主要影响因素.而以“提高自身能力”为动机参与教学活动(OR:1.920,P=0.002)是提出“接受系统教学能力培训”需求的唯一独立影响因素.结论 住院医师参与教学工作和接受教学培训的人员比例明显低于主治医师,低学历的初年住院医师更容易对自身教学能力缺乏自信,但他们希望接受系统教学能力培训的需求并未因此而增强,而以“提高自身能力”为动机参与教学活动的人员更多地提出了希望接受系统教学能力培训的需求.在青年医生中倡导“教学相长”的理念,增加住院医师参与教学活动和强化住院医师的教学能力培训或将有助于提高住院医师的教学水平.“,”Objective To investigate the feelings of young physicians engaged in clinical medical education,and their training backgrounds in teaching ability,to learn their difficulties and the need for helps.Methods 437 attending physicians and residents on training program (including PGY1-5),in Peking University First Hospital were enrolled in this retrospective study.Questionnaire investigation was used to collect the information about their motivations and feelings to engage in clinical medical education,their training backgrounds in teaching ability,the difficulties they met and the helps they needed in clinical teaching.Main elements were compared between the attending physicians and residents,multivariable logistic regression analyses was used to determine the independent relative factors of their feelings,difficult experience and helps needed,what were focused by most of subjects.Results Effective rate of questionnaire investigation was 99.3％ (437/440 questionnaire distributed).The actual sampling size in attending physicians population was 66.3％ (126/190 peoples),and was 61.1％ (311/509 peoples)in residents.In all subjects (n =437),84.7％ (370 people) were actually engaged in clinical education,55.6％ (243 people)thought that they were passively involved,and these ratio were significant higher in attending physicians population than in residents (P＜0.05).Engaging in clinical teaching was estimated as a favorite by 67.7 ％ (296 people),90.4％ (395 people) considered that clinical teaching is beneficial to the improvement of themselves,and 50.3％ (220 people) thought that they need systemic training in education,no significant difference was found between attending physicians and residents in terms of self-identification ratio in above confessions.Trainings in education was significantly more experienced in attending physicians than residents (P＜0.05),and the difficult experience of “insufficient in knowledge and ability to support the clinical teaching” was significant more frequently reported by residents than attending physicians(P＜0.05),multivariable logistic regression analyses showed that actual engaging in clinical teaching(OR:2.733,P=0.001),and the motivations to engage in clinical education,for self-improvement in competence (OR:5.677,P =0.000) ; enthusiasm for teaching the doctors of next generation (OR:4.752,P=0.000),were the independent enabling factors producing the feelings of favorite in clinical education.Years on working or on training (OR:0.752,P =0.003),educational background (OR:0.581,P=0.001),and the motivations to engage in clinical education,for self-improvement in competence (OR:1.833,P =0.005),enthusiasm for teaching the doctors of next generation (OR:1.863,P =0.026),were the independent relative factors for the difficult experience of “insufficient in knowledge and ability to support clinical teaching”.However,the motivations to engage in clinical education,for self-improvement in competence(OR:1.920,P =0.002)was the unique independent enabling factor for the need of systemic training in education.Conclusions The ratios of engaging in clinical teaching and having trainings in education were significant lower in residents than in attending physicians.The need for systemic training in education did not increased in junior residents who were more likely to be less self-confident in teaching due to the shortage of knowledge and ability,but it did in the population who engaged in clinical education for self-improvement.Encouraging the residents to teach,training the residents to teach and advocating the idea of “teaching is learning” in the residents population,would be enable and beneficial for augmentation of residents teaching level.