中国全科医学 ›› 2018, Vol. 21 ›› Issue (16): 1993-1997.DOI: 10.3969/j.issn.1007-9572.2018.16.018

• 专题研究 • 上一篇    下一篇

临床医学专业本科生对全科医师规范化培训的意愿及其影响因素研究

马琳琳,陆媛*   

  1. 200090上海市,同济大学附属杨浦医院全科医学科
    *通信作者:陆媛,硕士生导师,副主任医师;E-mail:lussy@123.com
  • 出版日期:2018-06-05 发布日期:2018-06-05
  • 基金资助:
    上海市卫生计生系统重要薄弱学科建设计划基金(2015ZB0603)

Intention and Associated Factors of Participating in the Standardized General Practitioner Training among Clinical Medical Undergraduates 

  1. Department of General Practice,Yangpu Hospital,Tongji University,Shanghai 200090,China
    *Corresponding author:LU Yuan,Master supervisor,Associate chief physician;E-mail:lussy@123.com
  • Published:2018-06-05 Online:2018-06-05

摘要: 目的 了解同济大学大四临床医学生对全科医师规范化培训的意愿及其可能的影响因素。方法 采取整群抽样法,以同济大学的全体大四临床医学生(排除13例外国留学生)为研究对象,共计117例。于2016年11—12月,采用自行设计的调查问卷对117例学生进行问卷调查。问卷的主要内容有:学生的基本情况,学习《全科医学概论》前后对全科医学的了解程度及收获,毕业后对全科医师规范化培训的意愿,吸引学生选择全科医学的原因及排斥选择全科医学的原因。共发放问卷117份,回收有效问卷117份,问卷的有效回收率为100.0%。结果 117例学生学习《全科医学概论》前后对全科医学的了解程度比较,差异有统计学意义(P<0.001)。117例学生学习《全科医学概论》后最大的收获为了解全科与专科区别、了解全科基本理论、改变择业方向者分别占65.0%(76/117)、33.3%(39/117)、1.7%(2/117);在学习《全科医学概论》的过程中,对社区参观、全科思维、慢性病管理感兴趣者分别占48.7%(57/117)、37.6%(44/117)、13.7%(16/117)。117例学生毕业后接受全科医师规范化培训的意愿为非常愿意、比较愿意、一般愿意、非常不愿意者分别占2.6%(3/117)、15.4%(18/117)、55.5%(65/117)、26.5%(31/117)。不同性别、户口、第一志愿是否为医学、父母最高文化程度的学生毕业后接受全科医师规范化培训的意愿比较,差异无统计学意义(P>0.05)。认为吸引其选择全科医学的原因排在前3位的是工作压力小(91.5%,107/117)、医患关系和谐(90.6%,106/117)、性价比高(74.4%,87/117);毕业后排斥选择全科医学的原因排在前3位的是薪资较低(92.3%,108/117)、社区硬件水平欠佳(90.6%,106/117)、认为全科全而不精(87.2%、102/117)。结论 学习《全科医学概论》后,学生对全科医学的了解程度增加,收获较多。非常愿意接受全科医师规范化培训的学生比例过低,且多数学生对全科医生和全科工作存在认识误区。因此,需要进一步加大全科医学的宣传力度,强调在医学生本科阶段完善全科医学教育的重要性。

关键词: 临床医学, 全科医师规范化培训, 择业, 影响因素分析

Abstract: Objective To examine the intention and associated factors of participating in the standardized general practitioner training (SGPT) among senior clinical medical students from Tongji University.Methods From November to December 2016,we conducted a survey in a cluster sample of totaled 117 Chinese senior clinical medical students (13 foreign students were excluded) from Tongji University with a self-designed questionnaire for collecting the demographic data,understanding level of general medicine before and after learning Introduction to General Practice,benefits from learning Introduction to General Practice,intention of participating in the SGPT after graduation,and reasons for becoming a general practitioner or not after graduation.All of them (100.0%) responded to the survey positively.Results The understanding level of general medicine improved significantly among the students after learning Introduction to General Practice (P<0.001).The greatest benefit from learning Introduction to General Practice for 65.0% (76/117),33.3% (39/117),1.7% (2/117) of the participants was "understanding the difference between general and specialty medicine" "understanding the basic theory of general medicine" "changing the view of career selection",respectively.During the learning of Introduction to General Practice,48.7% (57/117),37.6% (44/117),13.7% (16/117) of the students showed interest in "visiting community healthcare settings" "general practitioner's clinical thinking" "chronic disease management",respectively.The proportion of students who were very willing,comparatively willing,fairly willing,very reluctant,to participate in the SGPT after graduation was 2.6% (3/117),15.4% (18/117),55.5% (65/117),26.5% (31/117),respectively.The intention of participating in the SGPT after graduation did not differ significantly by sex,hometown location,medicine as the first-choice major,and higher level of parents' educational attainment (P>0.05).The top 3 reasons for becoming a general practitioner after graduation were" low working pressure " 〔91.5% (107/117)〕,"harmonious doctor-patient relationship in primary care" 〔90.6%(106/117)〕,"good pay-for-performance" 〔74.4% (87/117)〕.For not to be a general practitioner after graduation,the top 3 reasons were "comparatively low payment" 〔92.3% (108/117)〕,"poor hardware configuration in community healthcare settings" 〔90.6% (106/117)〕,and "the career of the general practitioner aiming at knowing all fields but mastering none" 〔87.2% (102/117)〕.Conclusion The understanding level of general medicine was deepened through the learning of Introduction to General Practice and the students gained a lot during the process.However,only a small number of them were willing to receive the SGPT after graduation,and most of them had inadequate understanding of the career of general practitioner and primary care.In view of this,general medicine should be publicized further,and the importance of improving the general practice education for clinical medical undergraduates should be emphasized.

 

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