关键词: 全科医生, 医教协同, 沟通技能, 培训需求, 影响因素分析

Abstract: Background　The synergy of health care system and medical educational system aims to foster healthcare talents with a priority on general practitioners（GPs），which is a key to improving health care. Communication skills are one of the core competencies that GPs must master. Although China has opened doctor-patient communication training courses for GPs，the training effect is poor. Studies have demonstrated that the demand-oriented training model may quickly meet the clinical needs and significantly improve the quality of teaching. Objective　To explore the training needs and influencing factors of GPs under the synergy of health care system and medical educational system. Methods　By use of cluster sampling，we selected the community base of West China Hospital-community consortium for standardized training for GPs in October 2018，and invited 104 GPs from all the 12 community health centers in the consortium to participate in a structured questionnaire survey for collecting their demographic characteristics，perceived importance of doctor-patient communication，previous trainings of doctor-patient communication，needs of related trainings and intention to attend such trainings，and perceived influencing factors for doctor-patient communication. Binary logistic regression analysis was used to analyze the influencing factors associated with training needs of communication skills. Results　The survey achieved a 100.0% response rate. Among the respondents，95.2%（99/104）believed that doctor-patient communication was important，and 66.3%（69/104）had attended trainings in doctor-patient communication. The top topic that 82.6%（57/69）of participants had been trained was "building a healthy relationship"，the bottom was "empathy training" with 29.0%（20/69）. All the respondents had the training needs for communication. The top topic that 71.8%（61/85） of participants would like to be trained was "shared decisions making"，and the bottom was "history taking" with 16.4%（17/104）. Binary logistic regression analysis found that training needs was influenced by gender，age，education level，previous training experience，self-rated communication skills and doctor-patient relationship satisfaction（P<0.05）. The commonest barrier to doctor-patient communication was "lack of time and energy due to busy work"，followed by "lack of skills to effectively communicate with patients". Conclusion　Under the synergy of health care system and medical educational system，the GPs attached great importance to doctor-patient communication，and demonstrated strong training needs and willingness. There are differences between previous training contents and training needs. Continuous and dynamic assessment of training needs is the key to ensuring the quality of such trainings for GPs.

Key words: General practitioners, Synergy of health care system and medical educational system, Communication skills, Training needs, Root cause analysis