上海市长宁区全科医生继续医学教育需求的质性研究

Survey on the needs of continuing medical education for general practitioners in Changning District,Shanghai

2019年3—5月对上海市长宁区的10家社区卫生服务中心的39名代表实施专题小组访谈。访谈地点为各单位会议室,每家单位访谈持续时间在30~90 min,访谈结束后对访谈相关资料进行编码、归类、精简,梳理出各访谈主题。结果提示,社区全科医生继续医学教育目前存在以下问题:对疾病相关临床指南等知识更新不及时;缺乏合理用药的统一规定;培训内容或形式与社区需求不匹配;心理、营养等相关培训无法转化成生产力。对继续医学教育提出如下诉求:建设疾病临床指南数据库;提供合理用药的信息化支持和指导;根据社区需求设计培训内容和培训形式;提供心理、营养等方面的培训支持;增加科教研、健康管理等其他培训。社区全科医生继续医学教育面临来自知识应用者、知识输出者、政策环境等多方面的问题,培训内容和形式都有待优化,而这些可以通过加强沟通、及时跟进受训者需求,针对不同类别的培训内容建立多样化的培训形式,建立配套的考核激励机制等方面入手。

From March 2019 to May 2019,panel interviews were conducted with 39 representatives of 10 community health service centers in Shanghai Changning District,each took 30 to 90 min.The relevant information of interviews was coded,classified,streamlined,and the interview topics were sorted out.The interviews showed the following problems of continuing education in community health care setting currently:there were lack of updated disease-related clinical guidelines and other knowledge,lack of uniform regulations on rational drug use;the contents or forms of training did not match the needs of the community;and training in psychology and nutrition therapy could not be transformed into practical application.The participants made the following suggestions for continuing medical education:to build a database of clinical guidelines for diseases;to provide information-based support and guidance for rational drug use;to design training contents and training forms based on community needs;to provide training support in psychology,nutrition and other subjects;to increase trainings in research,teaching and health management and other aspects.Continuing medical education for community general practioners faces problems from knowledge users,knowledge providers,and the policy environment.The contents and forms of training needs should be optimized.These can be strengthened by communicating with the community and following up with the needs of the community in establishing diversified training forms,supporting assessment and incentive mechanisms for different types of training contents.