我国高校附属医院开展全科医学住院医师规范化培训情况调查

Investigation on regidency training of general practice residents in affiliated hospitals of colleges and universities in China

目的了解我国高校附属医院全科医学住院医师规范化培训(简称全科住培)的发展现状。方法2019年12月,采用问卷调查法调查我国近189所开设临床医学专业高校的全科住培开展情况。问卷内容包括教学机构设置、师资、培训形式等。采用描述性统计方法分析调查结果。结果2010年、2017年和2019年我国内地高校开展全科住培的数量分别为35所、68所和117所,全科住培基地数量分别为42所、88所和169所。高校开展全科住培最多的是华东地区(35所),最少为西北地区(9所)。2019年,1929名临床基地全科医学科指导医师中,有472人(24.5%)参与过教学文章的发表,304人(15.8%)参与过教学课题开展,543人(28.1%)具有累计3个月以上的社区卫生服务中心工作经历;169家全科住培基地中,91家(53.8%)基地理论教学只采用讲授法,80家(47.3%)基地没有开展任何形式的形成性评价。结论高校附属医院全科住培发展迅速,但仍存在全科住培尚未完全普及、不同地域和不同类型高校的发展不均衡、指导医师缺乏社区实践经历、社区指导医师缺乏教学研究经历、缺乏形成性评价等问题。下一阶段,高校附属医院应继续扩大全科住培开展规模,加强师资培养,不断丰富教学评价手段,更好地发挥引领作用。

Objective To investigate the current situation and development trend of standardized training for general practitioners in affiliated hospitals of colleges and universities in China.Methods In December 2019,a questionnaire survey was conducted in all 189 clinical medical colleges in China.The content of the questionnaire includes the setting of teaching institutions,teachers,training forms and effects.Descriptive statistics were used to analyze the results.Results In 2010,2017 and 2019,the numbers of colleges and universities carring out standardized training for general practitioners in China's Mainland were 35,68 and 117 respectively,and the numbers of training centers were 42,88 and 169,respectively.The region with the largest number of colleges and universities developing training centers was the eastern region(35 colleges and universities),with the least being the northwest region(9 colleges and universities).In 2019,472(24.5%)of the 1929 teachers in the training centers had participated in the publication of medical education articles,304(15.8%)had participated in medical education projects,and 543(28.1%)had accumulated more than 3 months of work experience in community health service centers.Among 169 training centers in 2019,91(53.8%)used lecture-based learning as the only teaching method,and formative assessment was absent in up to 80(47.3%)training centers.Conclusions Although the residency training for general practice in colleges and universities has developed rapidly,there are still many problems and challenges.For example,it has not been popularized in colleges and universities,with unbalanced development of different regions and different types of colleges and universities,as well as college teachers lacking community practice experience,and community teachers lacking teaching and research experience,the absence of formative assessment,etc.In the next stage,the affiliated hospitals of colleges and universities in China should continue to expand the scale of residency training,strengthen faculty development,and constantly enrich teaching evaluation methods,so as to better play a leading role in its academic development.