英国全科医师培训经验介绍及其初步应用体会

An introduction to general practitioner training programme in the uk and reflection on its application

提高基层医疗服务的水平和质量,加强全科医师的培训力度,改进培训方法是关键。作为英国皇家全科医师学会(RCGP)国际培训(中国)的首批成员,笔者对英国全科医师培训方面的部分先进理念和技术,以及初步应用体会进行总结和介绍。英国全科医师培训中注重学习能力的培养,采用教育五步法,即了解事实、引导学生原因分析、问学生一般的处理原则、表扬学生、让学生思考该怎么做。成人学习方式的培养有助于全科医师产生持续学习的能力,因此会以学员的不同学习风格为基础建立学习小团队,并利用角色扮演、小组讨论、录像等技术达到更好的学习目的。学习过程中带教老师起着关键的作用,依据学员的不同学习类型制定带教大纲并采用个性化的教学方法;组织学员之间、学员对带教老师、带教老师之间等的反馈,这也是发现带教中的问题,促进带教技能提高的良好方法。问诊指南工具常被用在接诊技巧的培训中,有助提高接诊效率及年轻全科医师的培养。鉴于国情及传统的差异,英国全科医师培训经验的借鉴及应用对带教教师及学员均需要一个改变及适应的过程。实际应用中带教教师需要注意角色的改变,由单纯的讲授者,更多地转变为引导者与共同参与者。角色扮演、录像及问诊指南工具培训等培训技术改进获得全科培训学员较高的认同度,可更多应用于国内全科学员的培训中。对学员的考核需注重平时带教中学员表现的评价,同时不仅局限在理论、技术方面,更结合人文、伦理、法律、学习能力、协作、领导能力等方面的内容。英国全科医师的培养、培训经验的吸收运用有助于规范化全科医师的培训及全科人才的培养。

To improve the quality of primary medical care, it is crucial to strengthen the general practitioner （GP） train- ing and modify the training methods. As one of the first batch of participants receiving the RCGP （ Royal College of Gen- eral Practitioners） International （China） Training, I hereby give a brief introduction to the forward-looking ideas and ad- vanced technology of the GP training in the UK and shared my experience of its primary application. The GP training pro- gramme focuses on cultivating one＇ s learning ability in five steps ： learning facts guiding cause factor analysis Q＆A about general processing principle praise and approval independent thinking about solutions. The establishment of adult learning pattern can help GPs to develop continuous learning ability and thus trainees having different learning styles will be as- signed to form a study group to carry out various activities, such as role playing, group discussion and videotaping, in or- der to produce better learning outcomes. Clinical teachers play an important role in the GP training programme. They are responsible for formulating clinical teaching syllabuses, developing individualized teaching methods according to the trai- nees＇ learning styles and establishing a feedback system （ trainee to trainee, trainee to clinical teacher and between clini- cal teachers） that is effective in identifying problems in clinical teaching and bettering teaching skills. The diagnostic kit is usually applied to the clinical reception training so as to increase the reception efficiency and cultivate more and youn- ger GPs. Considering the differences in national situations and traditions between China and the UK, both of the Chinese clinical teachers and trainees are required to adapt themselves to the UK＇ s GP training programme for practical use. To be specific, clinical teachers should pay attention to the shift from the role of an instructor towards a guide and co-partici- pant. Since the optimized training techniques, such as role playing, videotaping and diagnostic kit training are widely recognized by the GP trainees, these techniques can be extensively applied to the GP training in China. With regard to trainee appraisal, clinical teachers should value their trainees＇ performance on cultural science, morality, legal compli- ance, learning ability, collaboration ability and leadership, as well as their understandings of theories and command of techniques. To learn from the UK＇ s GP cultivation and training is beneficial to standardize domestic GP training and cultivation.