摘要
背景全科医生是保障居民健康和控制医疗费用支出的“守门人”,是社区卫生服务的主要实施者和提供者,在基本医疗卫生服务中发挥着重要作用,其数量和质量直接决定着我国卫生服务提供的质量和效果。目的调查深圳市2008-2014年开展的全科医师规范化培训情况,总结其成功经验并发现存在的问题,为改进全科医师规范化培训制度提供依据。方法于2018年7-8月,通过自行设计的问卷,对2008-2014年已经毕业的深圳市全科专业规范化培训医师638例进行回顾性调查,调查内容包括基本情况、影响参加培训的因素、对实际工作帮助程度、效果最好的培训方式、与未参加规范化培训医生相比的优势和机会、培训满意度和需要改进的方面。结果共发放问卷638份,回收有效问卷523份,有效回收率为82.0%。深圳市开展的全科医师规范化培训人数逐年增加,由2008年的54人增长到2014年的131人。调查对象对培训总体情况满意人数所占比例为46.8%(245/523),其中全科医师培训的理论学习(52.0%,272/523)、理论课程师资水平(56.6%,296/523)、临床基地教学师资水平(52.0%,272/523)、社区实践教学(51.4%,269/523)、社区实践教学师资水平(51.2%,268/523)5项满意度超过50.0%。在工作岗位上较未参加规范化培训的全科医生,69.2%(362/523)、57.2%(299/523)、38.8%(203/523)的调查对象认为其优势主要在诊疗能力、学习能力、医患沟通能力等方面。全科医师规范化培训需要改进的方面排在前3位的分别为独立实践机会、带教师资的能力、整体轮转科室的安排。结论深圳市经过规范化培训的全科医生数量和质量稳步上升,培训取得初步成效。优化集中理论培训课程内容,改进临床和社区实践培训方式,有针对性地加强师资能力培养、加大带教激励力度、加强考核结果反馈等有助于进一步提升全科医师规范化培训质量。
Background General practitioners(GPs)are the"gatekeepers"of residents'health and the control of medical expenses.They are the main implementers and providers of community health services who play an important role in basic medical and health services.The quantity and quality of GPs directly determine the quality and effectiveness of health services in China.Objective This study retrospectively analyzed the standardized GP training in Shenzhen during 2008 to 2014,and summarized the successful experiences and discovered existing problems,in order to provide a basis for improving the reform and innovation of the standardized GP training system.Methods Through self-designed questionnaires,a retrospective survey was conducted from July to August,2018,on 638 GPs who participated in the standardized GP training and graduated from 2008 to 2014 in Shenzhen.The survey content included the basic information,factors affecting the participation in training,the degree of assistance to the actual work,the best way to train GPs,advantages and opportunities compared to GPs who did not participate in training,training satisfaction,and areas for improvement in the training.Results A total of 638 questionnaires were distributed,and 523 valid questionnaires were recovered with an effective rate of 82.0%.The number of GPs participating in the standardized GP training in Shenzhen had increased year by year from 54 in 2008 to 131 in 2014.The proportion of respondents who were satisfied with the overall training situation was 46.8%(245/523).Among them,five items whose satisfaction exceeded 50.0%were theoretical training(52.0%,272/523),faculty quality of theoretical courses(56.6%,296/523),faculty quality of clinical base teaching(52.0%,272/523),community practice teaching(51.4%,269/523),and faculty quality of community practice teaching(51.2%,268/523).Compared with GPs who did not participate in the training,69.2%(362/523),57.2%(299/523)and 38.8%(203/523)of the respondents believed that their advantages were mainly in the diagnosis and treatment ability,learning ability and doctor-patient communication ability,respectively.The top three areas need to be improved in standardized GP training were the lack of independent practice opportunities,teaching ability,and the overall arrangement of rotation within departments.Conclusion The quantity and quality of GPs participating in standardized GP training in Shenzhen have steadily increased with preliminary results.Optimizing the content of theoretical training courses,improving the training methods of clinical and community practice,strengthening the targeted training of teacher's ability,increasing the incentives for teaching,and strengthening the feedback of assessment results will help to further improve the quality of standardized GP training.
作者
刘建新
许幸之
常园园
饶昕
孙文民
卢祖洵
李阳
LIU Jianxin;XU Xingzhi;CHANG Yuanyuan;RAO Xin;SUN Wenmin;LU Zuxun;LI Yang(Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Shenzhen Health Capacity Building and Continuing Education Center,Shenzhen 518200,China)
出处
《中国全科医学》
CAS
北大核心
2021年第4期484-489,共6页
Chinese General Practice
基金
深圳市卫生计生系统科研基金项目(SZWG2018004)。
关键词
全科医生
住院医师规范化培训
深圳
General practitioners
Standardized training for resident
Shenzhen