全科医生转岗培训的需求与现状调查

Current status and training requirements for retraining program of general practitioner

采用问卷调查法，围绕社区卫生服务需求及服务项目开展情况、学员个人培训需求、培训现状三个方面对北京市第一届全科医生转岗培训学员84人进行调查。结果显示，社区卫生服务需求前3位的技能项目是心电图（98．8％）、实验室结果判读（96．4％）、换药（90．5％）。学员认为在社区中应该开展而尚未开展的项目有雾化吸入法（20人，23．8％）、体表小肿物切除（19人，22．6％）、X线阅片（17人，20．2％）等；未开展的原凶中认为与资源、设备、条件不足有关的占41．7％，与全科医生素质、技术、能力不足有关的占35．7％，与社区医生人力不足有关者占20．2％。个人需求培训项同比例最高的是常用X线阅片（64．3％），其次为心电图（54．8％）、常用化验检查的结果判读（51．2％）。目前大多数培训项目能够满足培训需求，但是某些项目如环甲膜穿刺术、耻骨上膀胱穿刺术、体表小肿物切除等培训情况不理想。提示，社区常用临床技能尚有广大的培训需求；目前的培训内容基本可以满足实际需求，但某些项目仍存在较大差距；社区卫生服务需求项目、学员个人需求项目应该成为今后培训的重点。

The current status and training requirements for general practitioner （GP） were surveyed with questionnaires in 84 trainees from the first Beijing GP retraining program. Results showed that three most demanded skills of health service in community were electrocardiogram （98.8%）, clinical lab results reading （96.4%）, dressing change （90. 5% ）. The services not provided but should be provided in community were aerosol rebreathing method （23.8%）, resection of small superficial lumps （22.6%） and reading X-ray films （20. 2% ）. The reasons for services not provided were insufficient resources （41.7%）, lack of skilled personnel （35.7%） and staffing shortage （20. 2% ）. The most required training skills were reading X-ray films （64. 3% ）, electrocardiogram （54. 8% ） and laboratoi3~ results reading （51.2%）. There were some skills inadequately trained including cricothyroid membrane puncture, suprapubic bladder puncture and resection of superficial small lumps. The results indicate that the required skills in community health service and individual demands of general practitioners should be the priority of the future training programs.