公立三甲医院医师继续医学教育现状及存在问题与对策

Current situation,existing problems and countermeasures of continuing medical education for physicians in public Grade A hospitals

目的了解公立三甲医院医师继续医学教育的现状,探讨存在的问题以及对策,为后续制定针对性的继续教育项目,提升继续教育质量提供科学依据。方法选取百色市右江区三所公立三甲医院的220名医师作为研究对象,对其进行问卷调查,采集一般人口学资料、对开展继续教育的内容和形式需求,并分析影响参加继续教育的相关因素。此外,选取15人进行半结构式访谈,了解目前公立三甲医院医师继续医学教育存在的主要问题。结果共发出问卷220份,有效问卷208份,有效回收率94.5%。单因素分析结果显示,年龄、性别、职称和学历与公立三甲医院医师对继续教育必要性认知有关(P<0.05)。多因素logistic回归分析结果显示,年龄30~<40岁(β=1.704,P=0.033,OR=2.927,95%CI=1.092~7.845)、中级职称(β=1.211,P=0.029,OR=3.357,95%CI=1.133~9.943)以及单位认为继续教育必要的态度(β=1.369,P<0.001,OR=3.931,95%CI=2.390~6.468)是影响三甲医院医师参加继续教育的独立影响因素。公立三甲医院医师在继续教育的内容、形式、时长和费用分担上有一定的倾向。既往参加过继续教育的116名研究对象满意度仅为61.2%。研究对象认为目前继续教育存在的主要问题集中在科室支持力度不够、继续教育的内容和形式个性化不足、工作太忙没有时间、精力参与继续教育。结论公立三甲医院医师继续教育必要性的认知还有加强,医院以及科室也要积极主动地为其提供继续教育的条件和机会。此外,继续教育的管理部门应根据参与继续教育的学员特点,提供个性化、满足其需求的培训方案,优化全区的继续教育体系,更好地促进公立三甲医院医师继续教育的质量提升。

Objective To understand the current situation of continuing medical education for physicians in public Grade A hospitals,discuss the existing problems and countermeasures,and provide a scientific basis for the subsequent development of targeted continuing education projects and improvement of the quality of continuing education.Methods A total of 220 physicians from three public Grade A hospitals in Youjiang District,Baise City were selected as the research objects.A questionnaire survey was conducted to collect the general demographic data of the research objects and their demands for the content and form of continuing education,and the influencing factors for participation in continuing education were analyzed.In addition,15 people were selected for semi-structured interviews to understand the main problems existing in the continuing medical education of doctors in third-class public hospitals.Results A total of 220 questionnaires were sent out,and 208 of them were returned with an effective response rate of 94.5%.Univariate analysis showed that ages,genders and educational backgrounds were associated with the cognition of the necessity of continuing education among doctors in public Grade A hospitals(P<0.05).The results of multivariate logistic regression analysis showed that the age of 30-<40 years old(β=1.704,P=0.033,OR=2.927,95%CI=1.092-7.845)and the intermediate professional title(β=1.211,P=0.029,OR=3.357,95%CI=1.133-9.943)and the attitude of unit that continuing education is necessary(β=1.369,P<0.001,OR=3.931,95%CI=2.390-6.468)were the independent factors affecting the participation of doctors in continuing education in public Grade A hospitals.Doctors in public Grade A hospitals have a certain tendency towards the content,form,duration and cost sharing of continuing education.Only 61.2%of the 116 participants who had taken part in continuing education were satisfied.The subjects believed that the main problems in continuing education at present were insufficient department support,insufficient personalized content and form of continuing education,and too busy to have time and energy to participate in continuing education.Conclusion The awareness of the necessity of continuing education for physicians in public third Class A hospitals should be strengthened,and hospitals and departments should also actively provide conditions and opportunities for continuing education for physicians.In addition,the management department of continuing education should provide personalized training programs to meet the needs of students participating in continuing education according to their characteristics,optimize the continuing education system of the whole region,and better promote the quality of continuing education for doctors in public Grade A hospitals.