Abstract: Background　To enrich the team of general practitioners（GPs） and promote the implementation of hierarchical diagnosis and treatment system，position transition training，which is the transitional training form for GPs，was launched nationwide in 2010.In 2017，the First Affiliated Hospital of Zhejiang University began to undertake some training tasks.Objective　By evaluating the effects of position transition training on GPs in the First Affiliated Hospital of Zhejiang University based on reaction level of Kirkpatrick model，we aim to gain a full understanding of subjective feelings of the trainees and to find problems in time，finally to provide a reference for the future training.Methods　Nine doctors who were trained from September 2017 to August 2018 in the First Affiliated Hospital，Zhejiang University were selected.In June 2018，a questionnaire link was sent to the trainees through the Wechat，and each trainee completed the questionnaire on the Internet.The questionnaire included the basic situation of the trainees，and the evaluation of the transition training base，self-improvement situation，and the current transition training methods.Results　Nine valid questionnaires were collected.For the evaluation of the theoretical training，8/9 of the trainees expressed "satisfied" or "very satisfied" with the number of class hours and the teaching level；7/9 of them were "satisfied" or "very satisfied" with the curriculum content.For the evaluation of the clinical training base，more than half of trainees were "satisfied" or "very satisfied" with the length of clinical training （7/9） and its contents（8/9），and all of them were "satisfied" or "very satisfied" with the quality of teaching.For the mastery of general practice theory，all of trainees thought their understanding of general medicine and doctor-patient communication ability had "moderate improvement" or "great improvement"；8/9 of them chose "moderate improvement" or "great improvement" for the appropriate technology in general practice.For the evaluation of the clinical comprehensive ability，8/9 of the trainees said that their ability of outpatient consultation had "moderate improvement" or "great improvement".For the evaluation of practical ability in general practice，all the trainees indicated that they had "moderate improvement" or "great improvement" in the diagnosis and treatment of common diseases and the teaching ability of general practice.All the trainees had participated in the teaching activities of general medicine in the First Affiliated Hospital of Zhejiang University，and thought that these teaching activities had improved their comprehensive ability 〔Outpatient consultation ability （9/9），self-study ability （9/9），teaching ability in outpatient clinic （8/9） et al〕.For the overall training effects，5/9 of trainees indicated "satisfied " and 4/9 of them were "very satisfied".For the “Aspects of the GP's position transition training system that need improvement”，7/9 of trainees suggested that the salaries of trainees should be reasonably increased；5/9 of them proposed that training methods should be more flexible and diverse，and meanwhile，they hoped to strengthen the training of clinical skills.And 5/9 of trainees had the contradiction between work and study.All the trainees expressed their willingness to register as GPs after the training，and 8/9 of them were willing to participate in the training that could strengthen GPs' ability in the future.Conclusion　The trainees generally have a good evaluation of the training and have improved their comprehensive ability through the training.But at the same time，we find some problems such as the difference in the requirements，lace of flexible training programs，the contradiction between work and study，and the weak organizational management et al．

Key words: General practitioner, Position transition training, Kirkpatrick model, Evaluation of reaction layer, Cross-sectional studies

摘要： 背景　为充实全科医师队伍，推进分级诊疗制度落实，全科医师转岗培训作为全科医师过渡期培训形式于2010年相继在全国范围内启动，且浙江大学医学院附属第一医院于2017年开始承担部分全科医师转岗培训工作。目的　从柯氏模型的反应层评估浙江大学医学院附属第一医院全科转岗培训效果，旨在全面了解学员的主观感受，及时发现存在的问题，为将来的转岗工作提供参考。方法　选取2017年9月—2018年8月在浙江大学医学院附属第一医院进行转岗培训的9名医师为调查对象。于2018年6月，通过转岗培训学员微信群发送调查问卷链接，学员各自于网上填写。调查问卷内容包括：学员基本情况、对转岗培训基地的评价、对自我能力提升情况的评价、对目前转岗培训方式的评价。结果　回收有效问卷9份。对理论培训阶段的评价：8/9的学员对学时数设置以及教学水平的评价方面表示“满意”或“很满意”，7/9的学员对课程内容设置表示“满意”或“很满意”；对临床培训基地的评价：超过一半的学员对培训时长（7/9）和培训内容（8/9）“满意”或“很满意”，对师资水平均表示“满意”或“很满意”。在全科医学理论方面：9名学员均表示通过理论课的学习，对全科医学的认识和医患沟通能力有“较大提高”或“很大提高”，8/9的学员在全科适宜技术方面有“较大提高”或“很大提高”。在临床综合能力的评价中，8/9的学员表示门诊应诊能力有“较大提高”或“很大提高”。在全科实践能力的评价中，所有学员表示自己在全科常见病诊治以及全科医疗教学能力方面有“较大提高”或“很大提高”。所有学员参加过浙江大学医学院附属第一医院全科医学科的教学活动，并认为这些教学活动提升了其综合能力〔如门诊应诊能力（9/9）、自学能力（9/9）、门诊带教能力（8/9）等〕。对于总体培训效果，5/9的学员表示“满意”，4/9的学员表示“很满意”。对于“全科医生转岗培训制度亟需改进方面”，7/9的学员认为应该合理提高培训人员工资待遇，5/9的学员提出培训方式应更加灵活多样，同时希望加强临床技能的培训。在工学矛盾方面，5/9的学员表示在参加全科医生转岗培训过程中存在一定的困难。所有学员表示愿意在培训结束后注册为全科医生，其中8/9的学员愿意以后继续参加加强全科医生能力的培训。结论　学员对培训总体评价较好，也从培训中提升了自己的综合能力。但同时发现了一些问题，如需求不一、培训计划欠灵活、存在工学矛盾、组织管理待加强等。

关键词: 全科医生, 转岗培训, 柯氏模型, 反应层评估, 横断面研究