General medicine and sleep medicine are two emerging clinical disciplines in China. They have many common things with complementarity in their own developments, and some crossovers in academic development of disciplines and talent training. The China National Accreditation Service for Conformity Assessment has opened up a way for general practitioners to engage in sleep medicine, which may be a basis and a necessity for sound cooperative development of general medicine and sleep medicine. We analyzed the basis and necessity of the cooperative development of general medicine and sleep medicine, introduced relevant experiences of Nanjing Medical University Affiliated Wuxi People's Hospital in the co-construction of general medicine and sleep medicine, and invited relevant experts to discuss the current issues.
As the most basic unit of infectious disease prevention and control, community health service institutions are the frontline and important gateway for the prevention and control of infectious disease. Primary care physicians are responsible for epidemic surveillance, vaccination, health promotion and assistance to centers for disease control in investigating and disposing outbreaks and public health emergencies in their districts, and play an active role in disease prevention and control by groups, susceptible population protection, infectious source control and health education, as well as the effective prevention and control of infectious diseases.
To understand the ability of primary care physicians to diagnose and treat infectious diseases in the community, analyse their existing problems and shortcomings, design and conduct a series of intensive training related to infectious diseases for improving the capacity of infectious disease prevention and control at the primary level; To evaluate the effectiveness of online continuing medical education, so as to provide a reference for better continuing medical education on infectious diseases in the community.
All participants of the National Community Infectious Diseases Continuing Education Conference held by the Department of Family Medicine of the University of Hong Kong-Shenzhen Hospital in November 2021 were selected as research subjects from November 2021 to March 2022. The questionnaires were distributed to all registered attendees before and after the conference through the QR code of the questionnaire star, and the content of pre-conference questionnaire included demographic characteristics of the participants, participation in infectious disease training in the community since started working, diagnosis and treatment of infectious diseases in the community, subjective attitudes towards the prevention and control of infectious diseases in the community (willingness to manage infectious diseases in the community, satisfaction with their own infectious disease management skills), expertise in infectious disease prevention and control and knowledge related to conference content, attitude towards hepatitis B. The content of the post-conference questionnaire mainly included knowledge about the content of conference, attitude towards hepatitis B and satisfaction survey of this online conference. A total of 301 primary care physicians completed the questionnaire before and after the conference, and a total of 194 completed the questionnaire before and after the conference.
Among all participants, 166 (55.1%) had attended infectious disease training in the community, of whom 49 (29.5%) were satisfied with their infectious disease diagnosis and treatment ability; 135 (44.8%) had not attended the training, of whom 22 (16.3%) were satisfied with their infectious disease diagnosis and treatment ability. 143 (86.1 %) of 166 participants who had attended infectious disease training in the community indicated their willingness to manage community infectious diseases, 99 (73.3%) of 135 participants who had not attended infectious disease training in the community indicated their willingness to manage community infectious diseases. 66 (27.3%) of participants who were satisfied with their infectious disease diagnosis and treatment ability indicated their willingness to manage community infectious diseases. The top three infectious disease tests conducted by the institutions were hepatitis B, AIDS, and hepatitis C; the top three infectious diseases treated in the past six months were hepatitis B, influenza, hand, foot and mouth disease. Different self-evaluation and willingness to train may affect the willingness to manage community infectious diseases (P<0.05). Among the participants who completed the questionnaire both before and after the conference, the highest correct answer rate for compulsory management of statutory infectious diseases before the conference was 89.7%, the lowest accuracy rate for the type of disinfection of the COVID-19 infection was only 17.0%, the correct rates of other questions ranged from 34.0% to 40.7%. The correct rates of the questions after the conference were higher than those before the conference, and the correct rates ranged from 48.9% to 52.6%. The score of attitude towards hepatitis B after the conference was higher than that before the conference (P<0.05). In terms of feedback after conference, 254 (98.1%) expressed satisfaction in the total of 259 questionnaires. In terms of suggestions for online conference, 179 (69.1%) and 174 (67.2%) participants believed that online fluency and online interaction need to be improved.
The primary care physicians receive relatively less infectious diseases training in the community, inadequate infectious diseases training in the community can improve the confidence of self-competence, attitude of active management of infectious diseases and diagnosis and treatment ability in the primary care physicians. The future direction of continuing medical education should focus on the training of emerging infectious diseases and novel medical concepts, relevant experts should be invited to comment on the necessity and effectiveness of training in the community.
