上海市长宁区全科医生对全科医学知识技能的掌握情况及培训需求分析

GPs′ general practice knowledge and skills and their training needs in Changning District of Shanghai

【目的】了解和掌握上海市长宁区全科医生对全科医学知识技能的掌握情况和培训需求,为制定规范有效的培训计划提出切实可行的对策建议。【方法】采用自行设计的问卷,对区属10家社区卫生服务中心所有全科医生及中心主任、副主任、质控科长进行调查。【结果】共发放问卷248份,回收238份,应答率为96.0%。76.8%的全科医生愿意或非常愿意参加相关知识技能的培训,选择半脱产培训的占40.6%,选择网络教学的占43.4%。选择病例讨论培训方式的占32.8%,选择临床接诊考核方式的占22.1%。相关理论和技能中,全科医学基本原则和服务模式、常见症状的鉴别诊断和处理、心血管系统常见疾病相关知识和技术、病史采集和病历书写掌握率较高,分别为62.8%、47.9%、47.9%、69.7%。传染病监测与报告、姑息治疗与临终关怀相关理论、社区妇女保健、社区儿童保健、社区卫生服务中的卫生经济学知识未掌握率较高,分别为3.0%、3.0%、3.9%、3.8%、9.9%。培训需求率较高的是全科医疗中的用药原则、常见急症的处理原则、X线和心电图的图像识别,分别为68.8%、77.7%、75.5%。【结论】长宁区全科医生的培训需求比较迫切,希望培训方式更贴近临床实际,网络教学比较受欢迎,应多增加实际操作技能的考核。培训内容方面,在侧重临床能力提升的同时,还应重视公共卫生知识、心理治疗、康复技术、相关法律知识的培训。

[Objective] To ascertain the mastery and training needs of general practitioners(GPs) for the knowledge and skills of general practice in Changning District of Shanghai,and to put forward practical and feasible measures for the development of standardized and effective GPs' training programs.[Methods] A self-designed questionnaire was used to investigate all GPs in 10 community health service centers.[Results] A total of 248 questionnaires were distributed and 238 of them recovered,with a response rate of 96.0%.And 76.8% of GPs were willing or very willing to participate in the training of relevant knowledge and skills,40.6% of them chose part-time training,and 43.4% of them chose online teaching.32.8% of them chose the training method of case discussion,and 22.1% of them chose the assessment method of clinical reception.The mastery rates in the basic principles and service models of general practice,the differential diagnosis and treatment of common symptoms,the knowledge and technology related to common diseases of the cardiovascular system,the collection of medical history and the writing of medical records among the relevant theories and skills were relatively higher,which were respectively 62.8%,47.9%,47.9% and 69.7%.The failing rate in the mastery of the knowledge on infectious disease surveillance and reporting,palliative care and hospice care theory,community women′s health care,community children′s health care and health economics of community health services were respectively 3.0%,3.0%,3.9%,3.8% and 9.9%.The higher rates in training needs were the principle of medication in general medical treatment,the treatment principle of common emergencies and the image recognition of X-ray electrocardiogram,which were respectively 68.8%,77.7% and 75.5%.[Conclusion] The training needs of GPs in Changning District are more urgent.Meanwhile,it is hoped that the training methods should be closer to clinical practices,online teaching should be adopted as it is more popular with GPs,and the assessment of practical operating skills should be increased.In terms of training content,while focusing on the improvement of clinical ability,we should also pay attention to the training of public health knowledge,psychotherapy,recovery technology and related legal knowledge.