澳大利亚的全科医生持续职业发展--以服务质量保障和病人安全为主题

Experience of Continuing Professional Development of General Practice in Australia:Quality assurance and patient safety as system approach

本文介绍和讨论全科医生持续职业发展的国外经验,并对我国全科医学人才队伍持续发展提出建议。澳大利亚采用国际上持续职业发展的理论,以质量保障和病人安全为主题,制定和实施了新一轮全科医学持续职业发展项目。该项目以富于弹性的设计,侧重满足全科医生个体化和多样性的需要,请全科医生主动参与持续职业发展的设计,通过主动学习、临床审计、循证医学俱乐部、全科医学研究、快速PDSA循环、临床实践、学位课程学习、参与职业考试等多种形式,有效地使全科医生在知识、技能、态度、行为和才智上得到收获。我国全科医生的持续职业发展依然在探索之中,师资和相应资源的缺乏、持续职业发展理念上的欠缺、与全科医学人力资源开发相关的政策协调问题,是全科医生持续职业发展的主要障碍。从战略上把继续医学教育转变为全科医生持续职业发展,研究制定中国全科医生持续职业发展的目标和主题,设计和实施适合全科医生需要和特点的项目活动。

To explore and discuss experience of continuing professional development in Australian and provide policy recommendation to Chinese GP training program. A quality assurance and continuing professional development program for the next triennium has been implemented by RACGP Australia. Patient safety and quality assurance have been identified as theme of the plan. The QA＆CPD targets on satisfy GP need and enhance program＇s depth, flexibility and standard. GPs involved in the process of program design and learning. The program provides wide range of opinions of CPD, such as active learning, clinical audit, EBM journal club, GP research, learning plan, rapid PDSA, small group learning supervised clinical attachment, higher education and college assessment activities. The program aims on significantly improving of GP＇s knowledge, skills, attitude, behavior and competence. Chinese community doctor training program is facing shortage of resources and lack of philosophy of continuing professional development. The weakness of GP CPD in China is a barrier of patient safety and service quality in com- munity health services. Changing from continuing medical education to continuing professional development is a strategic system change approach. Based on international experience and Chinese context of CPD, further researches need to be conducted for supporting better system design of CPD for community doctors.