Since October 2020, relying on the teaching resources and experience of Department of General Practice of Sir Run Run Shaw Hospital, a three-stage hierarchical progressive teaching and training of "teacher training-backbone training-continuous training" has been carried out for general practitioners in People's Hospital of Deqing County and 12 subordinate primary care institutions in Deqing County.

To analyze the related efficiency of stratified stepped training for regional general practitioners from October 2020 to November 2021.

The stage competencies of 14 senior faculty members were evaluated prior to participation in training (October 2020), at the end of rotation training of Department of General Practice of Sir Run Run Shaw Hospital (January 2021) and at the end of the 12-month training (October 2021) ; the competency evaluation covers five aspects: general practice occupational competence, general practice clinical competence, general practice skills, general practice teaching competence and general practice professional competence. The stage competencies of 28 core general practitioners were evaluated prior to participation in training (January 2021) and after completing the 12-month training (December 2021), the competency evaluation covers four aspects: general practice occupational competence, general practice clinical competence, general practice skills and general practice professional competence. The stage competencies of 82 junior echelon general practitioners were evaluated prior to participation in training (January 2021) and after completing the 12-month training (December 2021), the competency evaluation covers three aspects: general practice occupational competence, general practice clinical competence and general practice skills.

There were significant differences in general practice occupational competence among 14 senior faculty members (P<0.05) ; among them, the scores of general practice professional competence in the third month and the twelfth month of training were higher than those before training (P<0.05). There were significant differences in the scores of general practice clinical competence and general practice skills among the senior faculty members in different time points (P<0.05) ; the scores of general practice clinical competence and general practice skills in the third month and the twelfth month of training were higher than those before training (P<0.05). The scores of general practice teaching competence of senior faculty members in the twelfth month of training were higher than those in the third month of training (P<0.05). The scores of general practice professional competence, general practice clinical competence, general practice skills of 28 core general practitioners after training were higher than those before training (P<0.05). The scores of general practice professional competence, general practice clinical competence, general practice skills of 82 junior echelon general practitioners after training were higher than those before training (P<0.05) .

This study provides an orderly, robust and sustainable model of continuous training and ability improvement of regional general practitioners after practice with the leading and supporting of general hospitals, which can effectively enhance the competence level and improve job competency of regional general practitioners.

自2020年10月开始，依托邵逸夫医院的全科医学科教学资源和经验，德清县属德清县人民医院及下属12家基层医疗卫生机构全科人才开展了"师资培养-骨干培养-持续培训"三个阶段的分层递进式教学培养。

分析2020年10月至2021年11月开展区域全科医生分层阶梯式培训的相关成效。

对14名高级师资人才进行参与培训前（2020年10月）、邵逸夫全科科室轮转培训结束时（2021年1月）和总体完成12个月培训时（2021年10月）的阶段能力评价，能力评估涵盖全科职业能力、全科临床能力、全科实践技能、全科教学能力、全科专业能力5个方面；对28名全科骨干医师参与培训前（2021年1月）和总体完成12个月培训时（2021年12月）的阶段能力进行评价，能力评估涵盖全科职业能力、全科临床能力、全科实践技能、全科专业能力4个方面。对82名初级梯队全科医师参与培训前（2021年1月）和总体完成12个月培训时（2021年12月）的阶段能力进行评价。能力评估涵盖全科职业能力、全科临床能力、全科实践技能3个方面。

14名高级师资不同时间全科职业能力评分比较，差异有统计学意义（P<0.05）；其中培训第3个月、培训第12个月全科职业能力评分均高于培训前（P<0.05）。高级师资不同时间全科临床能力与全科实践技能评分比较，差异有统计学意义（P<0.05）；培训第3个月、培训第12个月全科临床能力与全科实践技能评分均高于培训前（P<0.05）。高级师资培训第12个月全科教学能力评分高于培训第3个月（P<0.05）。28名全科骨干医师培训后全科职业能力评分、全科临床能力与全科实践技能评分均高于培训前（P<0.05）。82名初级梯队全科医师培训后全科职业能力评分、全科临床能力与全科实践技能评分均高于培训前（P<0.05）。

本研究提供了一种有序、有力、可持续开展的综合医院引领、扶持区域全科医学人才执业后持续培训、能力提升模式，能够有效提升区域全科医生的能力水平，提高岗位胜任力。