中国全科医学 ›› 2022, Vol. 25 ›› Issue (28): 3544-3549.DOI: 10.12114/j.issn.1007-9572.2022.0192

• 论著·全科医学教育研究 • 上一篇    下一篇

河北省助理全科医生培训基地评估情况及对策建议

张敏1, 宋世彬1, 李术君2, 张金佳1, 钱卫国2, 周志山2, 王荣英1,3,*()   

  1. 1050000 河北省石家庄市,河北医科大学第二医院全科医疗科
    2050000 河北省石家庄市,河北省卫生健康委科技教育与国际合作处
    3050000 河北省石家庄市,河北省医师协会全科医师分会
  • 收稿日期:2022-03-04 修回日期:2022-07-05 出版日期:2022-10-05 发布日期:2022-08-15
  • 通讯作者: 王荣英
  • 张敏,宋世彬,李术君,等.河北省助理全科医生培训基地评估情况及对策建议[J].中国全科医学,2022,25(28):3544-3549.[www.chinagp.net]
    作者贡献:张敏负责文章的数据整理、统计及文章撰写;张敏、宋世彬、张金佳负责文献检索、初步设计调查问卷、数据转录及核对;李术君、钱卫国、周志山、王荣英负责评估工作的组织实施、专家培训;张金佳、王荣英负责文章的可行性分析、质量控制及审校;王荣英对文章整体负责,监督管理。
  • 基金资助:
    河北省政府资助课题研究项目(361004)

Assistant General Practitioner Training Bases in Hebei Province: the Assessment and Recommendations for Improvement

Min ZHANG1, Shibin SONG1, Shujun LI2, Jinjia ZHANG1, Weiguo QIAN2, Zhishan ZHOU2, Rongying WANG1,3,*()   

  1. 1General Practice Department, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
    2Department of Scientific Education and International Cooperation, Health Commission of Hebei Province, Shijiazhuang 050000, China
    3Hebei Medical Doctor Association General Practitioner Branch, Shijiazhuang 050000, China
  • Received:2022-03-04 Revised:2022-07-05 Published:2022-10-05 Online:2022-08-15
  • Contact: Rongying WANG
  • About author:
    ZHANG M, SONG S B, LI S J, et al. Assistant general practitioner training bases in Hebei Province: the assessment and recommendations for improvement[J]. Chinese General Practice, 2022, 25 (28) : 3544-3549.

摘要: 背景 助理全科医生培训是我国现阶段加强农村基层全科医生队伍建设的重要补充,河北省已连续开展5年助理全科医生培训工作。规范助理全科医生培训基地建设、确保培训质量,是提高我省农村基层医疗卫生服务水平的重要环节。 目的 了解2020年河北省助理全科医生培训基地评估情况,分析基地建设过程中存在的问题,并提出针对性的政策建议。 方法 于2020年7月27—31日,对河北省23家助理全科医生培训基地进行评估。主要评估依据为中国医师协会制定的《助理全科医生培训基地评估指标》,评估内容包括基本条件、培训管理、师资队伍、过程管理、质量控制、保障措施6个方面。同时,在每家基地随机抽取2~3名学员开展问卷调查,内容包括学员的一般情况、对助理全科医生培训的了解度、对助理全科医生培训的满意度、对助理全科医生执业前景的看法及农村执业意愿。 结果 23家基地中,15家(65.2%)合格,8家(34.8%)基本合格,无不合格基地。13家(56.5%)基地尚未独立设置全科医学科,11家(47.8%)基地的教学查房次数达标且落实规范,10家(43.5%)基地开展的小讲课和病例讨论次数达标且落实规范,8家(34.8%)基地2019年首次助理执业医师考试通过率≥85%,12家(52.2%)基地2019年首次助理全科医生结业考核通过率≥85%。共对50例在培学员开展问卷调查,对轮转科室设置满意者45例(90.0%)、对培训内容设置满意者45例(90.0%),对临床培训基地满意者46例(92.0%),对基层实践基地满意者43例(86.0%),对教学师资满意者47例(94.0%);认为助理全科医生执业前景较好者39例(78.0%);愿意到农村地区执业者26例(52.0%)。合格基地、基本合格基地学员的年龄、对助理全科医生培训相关政策了解度、对基层实践基地的满意度比较,差异有统计学意义(P<0.05)。 结论 河北省助理全科医生培训基地的全科医学科独立设置率较低,整体培训质量欠佳,学员对基层实践基地满意度不高。助理全科医生培训基地应加强全科医学科的设置和内涵建设,加强基层实践基地建设,规范过程管理,从而提高培训质量。

关键词: 全科医生, 助理全科医生, 教育,医学, 培训基地, 评估结果, 河北

Abstract:

Background

As an important supplement for strengthening the development of general practitioners (GPs) workforce in primary care in China's rural areas, the training for assistant GPs has been carried out in Hebei Province for five consecutive years. Standardizing the construction of the bases for training assistant GPs, and ensuring the quality of the training are key measures to improve the quality of primary care services in Hebei rural areas.

Objective

To understand the assessment of Hebei's assistant GP training bases in 2020, and put forward policy suggestions targeting the existing problems.

Methods

We conducted this study during July 27 to 31, 2020. We assessed the 23 assistant GP training bases in Hebei using the Assistant General Practitioner Training Base Assessment System developed by the Chinese Medical Doctor Association, involving general condition, training management, faculty team, process management, quality control and supporting measures. We also conducted a questionnaire survey with trainees randomly selected from these bases (two or three trainees chosen from each base) for understanding their socio-demographics, understanding of the training, satisfaction with the training, attitudes on the career prospect of an assistant GP, and level of intention to work in rural areas.

Results

The rates of qualified, basically qualified and unqualified bases were 65.2% (15/23) , 34.8% (8/23) , and 0, respectively. Thirteen 13 bases (56.5%) had not yet set up an independent general medicine department; 11 bases (47.8%) had qualified teaching rounds assessed in terms of number and implementation standards; 10 bases (43.5%) carried out small lectures and case discussions appropriately assessed in terms of number and implementation standards. The rate of passing the national Assistant Physician Licensing Examination once was≥85% in 2019 for trainees in 8 bases (34.8%) . The rate of passing the completion examination at the end of the training conducted for the first time in all bases in 2019 was≥85% for trainees in 12 bases (52.2%) . A total of 50 trainees attended the questionnaire survey. The prevalence of being satisfied with the design of the rotation of departments, training contents, clinical training base, primary care practice base, and the teaching team was 90.0% (45/50) , 90.0% (45/50) , 92.0% (46/50) , 86.0% (43/50) , and 94.0% (47/50) , respectively. The career prospect of an assistant GP was thought to be good by 39 trainees (78.0%) . Twenty-six trainees (52.0%) were willing to practice in rural areas. The level of satisfaction with policies related to the training for assistant GPs or primary care practice bases differed significantly by age in trainees regardless of whether the bases were qualified or basically qualified (P<0.05) .

Conclusion

In general, Hebei's training bases for assistant GPs were found with a low rate of setting an independent general medicine department, unsatisfactory training quality, and low trainee satisfaction. It is suggested that these training bases should strengthen the establishment of a general medicine department and connotation construction of general practice, improve the construction of primary care practice bases, standardize the process management, thereby improving the training quality.

Key words: General practitioners, Assistant general practitioners, Education, medical, Training base, Evaluation results, Hebei