目的 探讨对助产士进行层级培训的方法及效果。方法 便利选择2所三级甲等医院产房的68名助产士作为研究对象,干预前采用助产士能力评估工具表对其进行能力评估,按照得分将其分为新手层、胜任层、精通层和专家层,根据构建的助产士层级培训方案对其进行2年的培训,并根据考核结果对护士进行层级调整。比较培训前后各层级助产士理论与实践考核成绩,于培训周期完成时评价各层级流动升降级情况。结果 培训后,各层级助产士理论考试得分、各项实践技能考核评分均较培训前提高（均P<0.05）;68名助产士中,新手层由32名减少至13名,胜任层由22名增长至30名,精通层由12名增长至21名,专家层由2名增至4名。 结论 对助产士进行层级培训可以提升各层级助产士的理论水平和操作能力,有助于助产士层级的动态管理。

Objective To explore the methods and effects of training for midwives with different levels. Methods A total of 68 midwives in the obstetric departments of 2 tertiary hospitals were selected. Before the intervention,the Midwifery Competency Assessment Tool was used to assess their ability and they were divided into the novice level,competency level,proficiency level,and expert level according to their scores. Based on the constructed midwife-level training program,they were trained for 2 years. Level adjustment was performed based on the assessment results. The theoretical and practical assessment results were compared before and after intervention. The level changes were also evaluated. Results After the training,the scores of the theoretical examination and the scores of various practical skills of the midwives at all levels were improved compared with those before the training（all P<0.05）.The number of midwives of novice level was reduced from 32 to 13,the number of competency level was increased from 22 to 30,the number of proficiency level was increased from 12 to 21,and the number of expert level was increased from 2 to 4. Conclusion Level training of midwives can improve the theoretical and operational capabilities of clinical midwives at all levels,and achieve dynamic management.