The current training content of continuing education in general practice cannot meet the needs of clinical practice, as well as the lacking of thinking and characteristics of general practice in teaching faculty and evaluation methods.

To explore the training of clinical thinking in general practice through continuing education, so as to solve practical problems and improve working competence of general practitioners (GPs) .

The design of the 8th GPs' practice ability training workshop course was optimized based on the literature reading and feedback from the continuing education course of GPs' practice ability workshop in November 2020, and a questionnaire survey was conducted through the "wenjuanxing" platform among 200 GPs who participated in the 8th workshop course to evaluate the overall and various levels of improvement in their clinical thinking ability and working competence.

A total of 200 questionnaires were distributed, and 172 valid questionnaires were collected, with a recovery rate of 86.0%. After the training, 52.3% (90/172) and 21.5% (37/172) of the GPs had improved and greatly improved their overall clinical thinking ability in general practice, respectively, and 56.4% (97/172) and 22.1% (38/172) showed improvement and great improvement in overall working competence. There was a statistically significant difference in the improvement of clinical thinking ability and working competence among GPs with different professional titles and job types after training (P<0.05). There were 134 (77.9%), 134 (77.9%), 133 (77.3%), 127 (73.8%), 114 (66.3%) GPs who believed that "reading images" "clinical thinking ability in general practice" "interpretation of test indicators" "diagnosis and treatment of common dermatological and pentacologic diseases" and "scientific research training" could significantly improve the working competence of GPs. There were significant differences in the improvement of working competence by the course on "reading images" "clinical thingking ability in general practice" "diagnosis and treatment of common dermatological and pentacologic diseases" among GPs with different professional titles and job types (P<0.05). There was significant difference in the improvement of working competence by "scientific research" training course section in GPs of different genders (P<0.05) .

Optimized continuing education of general practice has a significant effect on the clinical thinking and working competence of GPs. In the design of training to improve the clinical thinking and working competence of GPs, it is also necessary to pay attention to the integration of various types of knowledge and skills in the training, and the practice experience base and accumulation of the trainees.

当前的全科医学继续教育存在培训内容无法满足全科临床实践需求，教学师资和评价方法也存在缺乏全科医学思维和特点等不足。

为解决全科医生实际工作问题，提升其岗位胜任力，通过继续教育培训探索对全科临床诊疗思维的培养。

2020年11月，在文献阅读和前期全科医生执业能力工作坊继续教育班课程的评估反馈基础上，对第八期"全科医生执业能力培训工作坊"课程进行优化设计，通过"问卷星"平台对参加第八期"全科医生执业能力培训工作坊"的200名全科医生进行问卷调查，评估其全科临床诊疗思维和岗位胜任力总体和各层面提升情况。

共计发放问卷200份，回收有效问卷172份，问卷有效回收率为86.0%。培训后，全科医生临床诊疗思维能力总体有较大提升和很大提升者分别占52.3%（90/172）和21.5%（37/172），岗位胜任力总体有较大提升和很大提升者分别占56.4%（97/172）和22.1%（38/172）。不同职称、工作类型全科医生培训后临床诊疗思维能力和岗位胜任力提升情况比较，差异有统计学意义（P<0.05）。分别有134名（77.9%）、134名（77.9%）、133名（77.3%）、127名（73.8%）、114名（66.3%）全科医生认为"识图读片""全科临床诊疗思维""检验指标解读""常见皮肤病、五官科疾病诊治""科研培训"可使全科医生岗位胜任力有较大以上提升。"识图读片""全科临床诊疗思维""常见皮肤病、五官科疾病诊治"课程版块可使不同职称、工作类型全科医生的岗位胜任力提升情况不同，差异有统计学意义（P<0.05）；"科研培训"课程版块可使不同性别全科医生的岗位胜任力提升情况不同，差异有统计学意义（P<0.05）。

优化的全科医学继续教育培训对于全科医生的临床诊疗思维和岗位胜任力都有明显提升作用。在提升全科医生临床诊疗思维和岗位胜任力培训设计方面，还需注意培训中各类知识技能的整合、受培训对象的实践经验基础。