Our state policy of free training of compulsory rural service oriented medical students (abbreviated as rural service orientation project) starts with the construction of a team of primary medical health talents and makes an excellent contribution to improve the accessibility and quality of medical services in rural areas of China. A comprehensive understanding of the current state of the rural service directed medical student team is important to evaluate the implementation effect of the free training policy, as well as the long-term development of the primary care health talent team.

To review the research progress of related studies on rural service orientation project in China and similar projects abroad, summarize the execution process and execution results of the projects inductively, and compare the similarities and differences between domestic and foreign studies.

The study was conducted from July to September 2021. A literature search for Chinese language was conducted in CNKI, Wanfang Data Knowledge Service Platform and VIP, and the search time was set from 2010-07-01 to 2021-07-01. A literature search in English was conducted in PubMed, web of science, Scopus, and the search time was set from 2000-01-01 to 2021-07-01. Literature screening was performed according to the inclusion and exclusion criteria, relevant information was extracted, and the literature was classified and analyzed according to the subjects and contents of the studies.

A total of 443 articles were finally included, with 427 of them on our rural service orientation project in China and the rest 16 on similar projects abroad. The research topics that were studied in the literature included four broad categories: cultivation mode, enrollment, training process, and employment development. In 427 related literatures of China's rural service orientation project: 102 (23.9%) discussed the training mode of rural service oriented project. Ten (2.3%) analyzed the admission status of rural service directed medical students and found that rural service directed medical students had higher awareness rate of the related policies (>75.0%-90.9%) and the proportion of rural students sources was higher (57.6%-84.2%). 270 (63.2%) literatures used the cultivation process of rural service directed medical students as a starting point and focused on their learning situation, professional identification and performance willingness, and found that rural service directed medical students had lower academic performance and professional recognition than general clinical medical students. The results of studies on the performance willingness of rural service directed medical students varied greatly (42.4%-98.4%), and the average performance willingness was 66.2% when weighted by sample size. Only 25 (5.9%) studied employment development in rural service orientated graduates and found an average performance rate of 93.6%. Rural service directed medical students had a faster rate of completing standardized residency training and passing practitioner examination than other five-year clinical graduates. Of the 16 foreign related literatures included, 11 (68.8%) examined the employment development of rural service directed medical graduates and obtained results similar to those of domestic studies.

A larger number of current studies focused on rural service oriented project and had rich topics. It was found that the rural service directed free medical student training policy was better implemented, leading to a large number of excellent primary health talents in the Midwest. However, most of the current research focuses on the cultivation stage of rural service oriented medical students, and there is insufficient understanding of medical students who have joined the primary care team at elementary level. Future research should focus on three aspects: performance status after rural service directed medical students having completed the contract period, career development process after employment and the actual role they play in primary health care institutions.

Compulsory rural service directed medical student free training program is an important initiative to ameliorate the shortage of health human resources in rural areas of China, and the first graduates of the policy have now completed the contract performance. Analysis of the performance situation and influencing factors of these students is needed to improve the policy of compulsory rural service directed medical student free training program in time and improve and stabilize the performance rate of the rural service directed medical students.

To analyze the employment and performance status of compulsory rural service directed medical graduates of 2015—2019 in four Midwestern medical schools, and to analyze the influencing factors on the performance of the rural service directed medical students, so as to make recommendations to further improve the training policy of the rural service directed medical students.

A cohort of rural service oriented medical students was established from four medical schools including Qinghai University, Guangxi Medical University, Jiujiang college, and Gannan Medical College, and other five-year graduates of clinical medicine from the same session were selected as controls. A baseline questionnaire was administered to graduates before graduation, which included the basic information, family information, job expectations, and so on. An online follow-up survey was conducted annually thereafter and included graduates' employment, performance status, and so on. This study was conducted in July 2021 using data from a baseline survey of graduates of 2015—2019 from four institutions and a follow-up survey from September 2020. A total of 2 041 rural service directed medical graduates and 1 579 other 5-year clinical students were enrolled. Compare the difference in employment between rural service oriented medical graduates and other five-year clinical students. Multivariate Logistic regression was used to analyze the influencing factors on the performance of rural service directed medical graduates.

In the baseline survey, 2.26% (46/2 038) of the rural service directed medical graduates were willing to work in township health institutes. In the 2020 follow-up survey, 86.04% (228/265) of the rural service directed medical graduates chose to work in township health institutes. In a 2018 follow-up survey of 2015 and 2016 rural service directed medical graduates, 43.67% (290/664) of graduates expressed reluctance to remain in township health institutes after the expiry of the contract. 97.48% (1 546/1 586) of rural service directed medical graduates were allocated as personnel in public institution, a higher proportion than other clinical 5-year graduates (P<0.05). The overall performance rate of 5-year rural service directed medical graduates was 97.84% (1 589/1 624), and the results of multivariate logistic regression analysis showed that male gender, desired job location as rural areas in the baseline survey, job having public institution quota, and contract location as home district (county) were the promoting factors for the performance of rural service directed medical graduates (P<0.05) .

Rural service directed medical students are more smoothly employed with high performance rates, and the recruitment of this type of medical students should focus on students who have willingness to work in rural areas and try to contract with the counties where the students are from.

The continuous development of the rural-oriented tuition-free medical education program has greatly contributed to the increasingly expanding of team of general practitioners in primary care. And the service status of targeted admission medical graduates has become a focus of current concern.

To explore the barriers faced by targeted admission medical graduates during the contracted period of providing primary care, and to propose corresponding countermeasures and suggestions.

From January to March 2021, 73 targeted admission medical graduates (admitted in 2010 & 2011) who were working in primary hospitals in Guizhou were selected to attend a semi-structured interview with an outline involving brief introduction of the development of their hospitals, job duties, job progression, main problems existing in work, capability areas for improvement, current situation of continuing education, current living conditions, level of targeted admission medical graduates valued by hospitals, future work plan, and so on. The interview results were analyzed in accordance with the procedures of grounded theory.

One hundred and twenty-seven concepts, 21 categories, 7 main categories (work environment, policy guarantee, family factors, future planning, psychology and perception, person-job fit and career development needs) were identified by an analysis, forming four axes: working practice (primary medical conditions, environment, management and other factors restrict the development of targeted admission medical graduates, and they hope to get more organizational support and suitable job arrangements) , family factors (part of targeted admission medical graduates affected by factors such as family distance and economic pressure during the service period, it is difficult to take into account the responsibility of family care) , internal demand (targeted admission medical graduates are prone to psychological and cognitive gaps, think that their personal abilities and development are limited, and hope for better career development prospects) , policy driving (policy factors run through all aspects of primary care for targeted admission medical graduates, and the implementation and promotion of some policies are insufficient and need to be further strengthened) .

The targeted admission medical graduates in Guizhou mainly faced difficulties in career development, ability improvement, caring for families, economic treatment and other aspects during the contracted period of providing primary care. To improve the situation, retain them in primary care as well as promote their career development, it is suggested to establish a mechanism for receiving their feedback, providing long-term trainings and guidance for them, allocate targeted admission medical graduates from other places, speed up the construction of regional medical consortiums, set up special subsidy funds, and clarify the arrangements after the expiration.

Social environment and psychological factors have a notable impact on professional identity. Currently, there are no available studies on relationships between perception of workplace violence (WPV) by patients, psychological capital (PsyCap) , and professional identity among general practitioners (GPs) in China.

To investigate the relationships between perceived WPV by patients, PsyCap, and professional identity among GPs in China.

A self-administered electronic questionnaire survey was conducted with 4 632 GPs selected by use of stratified multistage random sampling from eastern, central, and western China between March and May 2021. The survey was used for collecting data mainly consisting of GPs' basic demographics, perceived WPV by patients, PsyCap, and professional identity. Spearman's correlation was used to analyze relationships between perceived WPV by patients, PsyCap, and professional identity. Hierarchical multiple regression analysis was used to analyze the effects of perceived WPV by patients and PsyCap on professional identity.

Altogether, 94.47% of the GPs (4 376/4 632) who handed in responsive questionnaires were included for analysis. Six hundred and twenty-four (14.26%) GPs had experienced WPV by patients in the past year. The average total scores of PsyCap and professional identity were (102.89±16.94) and (33.93±8.95) , respectively. The increase in the score of perceived WPV by patients was correlated with a decrease in the scores of PsyCap and its dimensions, and in the score of professional identity (P<0.01) . The increase in the scores of PsyCap and its dimensions was correlated with increased score of professional identity (P<0.01) . Hierarchical multiple regression analysis showed that the frequency of WPV by patients had a negative predictive effect on professional identity (low frequency, b=-0.071; intermediate frequency, b=-0.054; high frequency, b=-0.042; P<0.001) . PsyCap had a positively predicted effect on professional identity (b=0.330, P<0.001) , and it played a partial mediating role between perceived WPV by patients and professional identity.

The GPs' perceived WPV by patients, PsyCap, and professional identity are interrelated, and PsyCap plays a partial mediating role between perceived WPV by patients and professional identity. Great importance should be attached to the professional work environment, occupational status, and mental health among Chinese GPs.

To strengthen the construction of health talents team in rural areas, a national compulsory services program (CSP) was started in 2010 in China. In 2015, the state required graduates of the CSP to participate in a 3-year standardized training for residents (residency) upon graduation.

To understand the participation of CSP graduates in residency, analyze the effect of residency on the pass rate of the practicing physician's examination for CSP graduates, and explore the significance of residency on the training of CSP graduates and the rural primary health workforce, so as to provide policy recommendations for the high-quality training of CSP graduates.

Starting in 2015, a cohort of CSP graduates was established from a total of 4 colleges undertaking CSP training programs in 3 provinces in the Midwest of China, and 1∶1 general clinical graduates who graduated the same year were selected as controls and followed up annually. Descriptive analysis was used to show the status of CSP graduates' participation in residency, the pass rate of the examination for practicing physicians, and to compare them with those of general clinical graduates. Stratified Cox regression was used to analyze the effect of attending residency on the pass rate of practicing physician exams.

86.69% (228/263), 86.78% (361/416), 87.79% (381/434), 91.08% (388/426), 94.43% (356/377) of the 2015—2019 CSP graduates stated that they were willing to participate in training after graduation, and 72.20% (200/277), 58.75% (151/257), 70.42% (169/240), 73.23% (145/198), 61.03% (83/136) of the same general clinical graduates stated that they were willing to participate in training after graduation. The actual participation proportions of CSP graduates in 2015—2019 in residency were 99.02% (202/204), 97.10% (301/310), 94.99% (322/339), 89.91% (285/317), 69.45% (241/347), 67.57% (100/148), 66.12% (80/121), 74.79% (89/119), 43.33% (39/90), 34.62% (27/78), respectively. The pass rate of practicing physician examination in 2015—2017 CSP graduates reached 99.23% (259/261), 94.86% (351/370), 91.74% (311/339), while the pass rate of same general clinical students was 97.74% (173/177), 95.87% (116/121), 88.24% (105/119), respectively. Cox regression results showed that after adjusting for demographic variables, family economic status, intention of studying medicine, medical education, and factors related to attending the residency, the probability of attending the residency group passing the practitioner's examination was 1.232 times higher than that of not attending the residency group 〔95%CI (1.02, 1.49), P=0.03〕.

CSP graduates' willingness to participate in residency training, the proportion of participation, and the pass rate of the qualifying examination for practicing physicians were all high. Participating in residency training can improve the ability of medical graduates and has a promoting effect on passing the qualifying examination of practicing physicians.

The training of targeted admission medical students (TAMS) is an important measure to alleviate the shortage of primary care physicians and to improve the overall quality and level of primary care workforce in rural China.

To explore the recent hot topics, present and future trends in the research on TAMS in China, so that a solid theoretical foundation can be laid for future studies.

All articles about the training of TAMS published from January 1, 2010 to December 31, 2021 in three databases (i.e., CNKI, WanFang Data and CQVIP) were searched on February 15, 2022. The number of the articles was counted for analysis. CiteSpace was used to conduct a visualization analysis of authors, research institutions and keywords extracted from the identified articles.

A total of 598 articles were finally included. The annual number of publications demonstrated an increasing trend generally during the period, with a peak in 2018 (n=81) . Five major groups of authors were identified. The top three prolific institutions were Gannan Medical University〔113 articles (18.9%) 〕, Guangxi Medical University〔40 articles (6.7%) 〕 and Xinxiang Medical University〔28 articles (4.7%) 〕. The top three high-frequency keywords were "order-oriented" (70 times) , "targeted admission students" (57 times) and "talent cultivation" (44 times) . Eight topic clusters were derived from keyword cluster mapping, namely "#0 learning motivation" "#1 teaching model" "#2 order-oriented cultivation" "#3 influencing factors" "#4 general medicine" "#5 primary care" "#6 medical college" and "#7 medical students". Knowledge map of keywords with the strongest citation bursts showed that the top three were "career identity" "major identity" and "rural primary care". The time-dependent graph indicated that the evolution of research on the training of TAMS could be roughly divided into three stages: education and training for TAMS at school, post-graduation training and education of TAMS, and current work status of TAMS in primary care.

The research on the training of TAMS in China is increasingly flourishing. Relevant policies are the major facilitators for the training of TAMS. The research is also featured by lack of inter-regional and inter-institutional coordination among related research institutions and authors. Moreover, the hotspots are constantly changing with the times, and the major topics about which can be summarized as follows: training models for TAMS, learning motivation of TAMS, and intention to work at primary care and associated factors in TAMS. The future research directions may be the evaluation of current work status and intention to work at primary care in a long-term period in TAMS, effectiveness of the implementation of policies related to the training of TAMS, and the innovative development of training models for TAMS.

In-depth interview is to understand the life experience and lifestyle of a certain social group through in-depth conversation with the respondents, explore the formation process of specific phenomena, and propose ideas and recommendations to solve problems. In-depth interview has been widely used in the study of primary care research. Thus, understanding its basic concept and mastering the design and application process are essential to master this method. This paper comprehensively describes the research process of in-depth interview research according to the 3 stages at before, during and after the research. Before formally conducting in-depth interview research, researchers need to understand its basic concepts, characteristics and limitations related to the research purpose and process, and identify which studies are applicable. In the design and implementation of in-depth interview research, researchers should focus on the main steps of the research in four stages: recruitment of interviewees, design and modification of interview guide, collection of interview data, and analysis of interview data. After completing the data analysis of the in-depth interview, researchers need to write a research paper referring to the report specification of qualitative research to increase the credibility of research results and the transparency of the research process. In addition, this paper recommends five fields suitable for in-depth interviews in primary care research, and introduces learning resources for researchers to master in-depth interview methods. Through the introduction of in-depth interview research method, this paper aims to help researchers in the field of general practice/primary care to master a method suitable for scientific research, and provide methodology reference for improving the quality of qualitative research in this field in China.

As healthcare gatekeepers, the competency of community general practitioners (GPs) will directly determine the quality of their services. However, the requirements for the competency of community GPs are still unclear and relevant applied research is scarce.

To construct a competency assessment system for community GPs.

An item pool of the first draft of the Onion Model-based Competency Assessment System for Community General Practitioners (OMCASCGP) was created by use of literature review in January 2021, then items in which were screened and improved in accordance with the results of two rounds of email-based expert consultation conducted with a purposive sample of 52 experts in general medicine and general medical management from February to March 2021. The weight of each index was determined by using the Analytic Hierarchy Process.

The response rate, authority coefficient, judgment coefficient and the degree of familiarity with the index for both rounds of consultation were 100.0% (52/52) , 0.91, 0.904, and 0.916, respectively. The formal system is composed of 6 first-level indices, 15 second-level indices and 48 third-level indices. The 6 first-level indices with corresponding weights are basic information (0.085 7) , clinical capability (0.436 1) , public health capability (0.244 5) , humanistic literacy (0.110 4) , career development (0.082 7) , and other aspects (0.040 6) . The Kendall's W measuring inter-expert agreement on the first-, second- and third-level indices was 0.254, 0.302, and 0.341, respectively (P<0.001) .

The OMCASCGP developed by us has been validated to be scientific and reliable, which could be appropriately promoted as a tool for assessing the comprehensive competencies of GPs.

The mental health of trainees receiving the three-year standardized general practice residency program (SGPRP) has been valued recently, and psychological problems are considered to be one major type of causes of their failure to complete the full training. So understanding the mental health status and associated factors of psychological problems in these GP trainees are of important significance for the development of residency training policies and programs.

To explore the mental health status and causes of psychological problems in GP trainees of SGPRP, improving the attention of SGPRP managers and the society given to the mental health of GP trainees.

This was a mixed-method sequential explanatory study. In January 2021, by use of convenience sampling, all in-service GP trainees of SGPRP were recruited from Peking University Shenzhen Hospital to attend a self-administered survey to complete the Demographic Questionnaire compiled by our research team and the Symptom Checklist 90 (SCL-90) . The total score and domain scores of the SCL-90 were analyzed overall, then were compared among the trainees by grade. For understanding the main life events triggering emotional or psychological problems and their associations with residency training program or specialty, and GP trainees' preferred assistance as well as suggestions for the development of SGPRP, from February to June 2021, purposive and heterogeneous sampling were used to recruit GP trainees with mental health assessment to attend an in-depth, semi-structured interview using phenomenological research procedure. The interview results were recorded, and transcribed, then coded using NVivo 12, and analyzed using Colaizzi's seven-step analysis and thematic analysis.

All GPs (n=84) responded to the survey, with a 100% response rate. The mean total SCL-90 score and the mean total symptom index for 84 GP trainees were (149.61±50.55) , and (1.66±0.56) , respectively. Of them, 29 (34.5%) had a total score≥160. The prevalence of obsessive-compulsive, depression, interpersonal sensitivity, anxiety, paranoid ideation, anger-hostility, psychoticism, somatization and phobic-anxiety (prevalence of symptoms in each domain was defined as domain score≥2) was 53.6% (45/84) , 39.3% (33/84) , 34.5% (29/84) , 26.2% (22/84) , 22.6% (19/84) , 21.4% (18/84) , 19.0% (16/84) , 14.3% (12/84) , and 14.3% (12/84) , respectively. The depression domain score varied significantly across GP trainees by grade (P<0.05) . The prevalence of depression was 48.4% (15/31) in grade 2 GP trainees. In total, 21 GP trainees attended the interview, 14 (66.7%) of whom had a total SCL-90 score≥160. Four themes emerged from the analysis: impact of personal problems on psychological status; harm and benefits caused by interpersonal interactions at work; psychological stress related to the residency base; lack of confidence related to specialty choice.

The high prevalence of psychological problems in GP trainees may be closely related to personal factors and problems encountered during residency training. In view of this, psychological guidance and crisis intervention should be listed as an important part of residency training management, and efforts should be made to enhance the trainees' sense of existence and belonging as well as self-confidence, thereby helping them to successfully complete the training.

As an important supplement for strengthening the development of general practitioners (GPs) workforce in primary care in China's rural areas, the training for assistant GPs has been carried out in Hebei Province for five consecutive years. Standardizing the construction of the bases for training assistant GPs, and ensuring the quality of the training are key measures to improve the quality of primary care services in Hebei rural areas.

To understand the assessment of Hebei's assistant GP training bases in 2020, and put forward policy suggestions targeting the existing problems.

We conducted this study during July 27 to 31, 2020. We assessed the 23 assistant GP training bases in Hebei using the Assistant General Practitioner Training Base Assessment System developed by the Chinese Medical Doctor Association, involving general condition, training management, faculty team, process management, quality control and supporting measures. We also conducted a questionnaire survey with trainees randomly selected from these bases (two or three trainees chosen from each base) for understanding their socio-demographics, understanding of the training, satisfaction with the training, attitudes on the career prospect of an assistant GP, and level of intention to work in rural areas.

The rates of qualified, basically qualified and unqualified bases were 65.2% (15/23) , 34.8% (8/23) , and 0, respectively. Thirteen 13 bases (56.5%) had not yet set up an independent general medicine department; 11 bases (47.8%) had qualified teaching rounds assessed in terms of number and implementation standards; 10 bases (43.5%) carried out small lectures and case discussions appropriately assessed in terms of number and implementation standards. The rate of passing the national Assistant Physician Licensing Examination once was≥85% in 2019 for trainees in 8 bases (34.8%) . The rate of passing the completion examination at the end of the training conducted for the first time in all bases in 2019 was≥85% for trainees in 12 bases (52.2%) . A total of 50 trainees attended the questionnaire survey. The prevalence of being satisfied with the design of the rotation of departments, training contents, clinical training base, primary care practice base, and the teaching team was 90.0% (45/50) , 90.0% (45/50) , 92.0% (46/50) , 86.0% (43/50) , and 94.0% (47/50) , respectively. The career prospect of an assistant GP was thought to be good by 39 trainees (78.0%) . Twenty-six trainees (52.0%) were willing to practice in rural areas. The level of satisfaction with policies related to the training for assistant GPs or primary care practice bases differed significantly by age in trainees regardless of whether the bases were qualified or basically qualified (P<0.05) .

In general, Hebei's training bases for assistant GPs were found with a low rate of setting an independent general medicine department, unsatisfactory training quality, and low trainee satisfaction. It is suggested that these training bases should strengthen the establishment of a general medicine department and connotation construction of general practice, improve the construction of primary care practice bases, standardize the process management, thereby improving the training quality.

The turnover intention level of general practitioners (GPs) in primary care in China is relatively high, and identification of its associated factors will offer insights into the curbing of outflow of health talents in primary care. The targeted admission medical graduates (TAMG) who completed the "5+3" standardized general residency program (5-year undergraduate medical education plus 3-year standardized residency training) have gradually entered primary care to fulfill their preadmission commitments, but research on their turnover intention after the tenure is few.

To explore the turnover intention and associated factors in Guizhou's TAMG trained with the "5+3" standardized general residency program after fulfilling their preadmission commitments in primary care, providing a basis for improving the policies about retaining the in-service health talents and developing the general practice workforce.

Participants were TAMG who were working in primary hospitals of Guizhou for fulfilling their preadmission commitments after finishing the "5+3" standardized general residency program at the end of 2020 (with a starting time for the 3-year standardized residency training of 2015—2017) . An online questionnaire survey was conducted with them from January 20 to February 10, 2021 for understanding their general information, self-assessed job satisfaction, turnover intention and planned career development after the expiration of services. Three hundred and eleven (89.6%) of the 347 cases who returned responsive questionnaires were selected as the final participants. Univariate and stepwise multiple linear regression analyses were used to explore the factors related to turnover intention.

The average turnover intention score for the respondents was (3.98±0.98) points. The prevalence of having turnover intention was 73.6% (229/311) . The level of turnover intention differed obviously by sex, hospital location, and daily workload (P<0.05) . Stepwise multiple linear regression analysis found that the way leaders treating their subordinates, sense of work-related, the level of satisfaction with current income, family's support for their job, the implementation of local incentive policies accomplishment were associated with turnover intention (P<0.05) . In terms of the post-expiration development, 12 (3.9%) planned to continue working at the current hospital, 21 (6.7%) planned to work at another primary care setting, 196 (63.0%) planned to work at a higher level hospital, and 60 (19.3%) planned to study full-time to get a master's degree.

The level of turnover intention was high in TAMG working as a GP in primary care in Guizhou, and it is estimated that many of them would outflow after the expiration of services. To improve this, it is suggested to value their needs, take actions to increase income and optimize trainings and employment forms for them, and to further develop primary care hospitals, as well as to strengthen the publicity of general practice.

District (county) hospitals are leading institutions delivering primary health services, which are responsible for providing local healthcare services, teaching and training medical talents, and carrying out medical research. However, their high-quality development has been restricted by limited scientific and technological innovation capability.

To review the studies published in recent 10 years on the treatment of clinical trial protocol violations, providing evidence for exploring paths to solve such violations during the cultivation of practical sci-tech innovation talents in district (county) hospitals.

In January 2022, studies on clinical trial protocol violations published between January 1, 2010 and December 31, 2021 were searched in databases of CNKI, WanFang Data, CQVIP, Baidu Wenku, PubMed, Medline, the Cochrane Library, Embase, and ClinicalKey using "临床试验" "医学伦理" "违规问题" as search terms in Chinese, and "Clinical Trial" "Ethical Issues" "Clinical Trial" "Ethical Problems" as terms in English. Clinical trial protocol violations were extracted and classified according to the nature of the violations. Systematic clustering algorithm was used to implement cluster analysis of the violations according to inter-cluster connection. Root cause analysis was used to explore the root causes of the violations.

The violations were divided into five classes (covering 27 subclasses) , and the first three were human subject protection (n=42, 33.6%) , clinical trial protocol (n=33, 26.4%) and informed consent (n=31, 24.8%) . Cluster analysis showed that the 125 violations could be grouped into two categories: authenticity (academic fraud) and compliance (violations) . The root causes of academic fraud and violations were as follows: insufficient research capability and low level of ethical knowledge in individuals or institutions; unsatisfactory punishment on individuals or institutions committing academic fraud; inadequate supervision of the sci-tech innovation achievements assessment and the ethical review system.

To solve academic fraud and ethical violations in trials, it is suggested to provide sci-tech innovation talents with practical ideology education on medical ethics that they should abide by in carrying out clinical trials by hospitals and colleges.

Talent team is a key factor that affects the service level and development of township hospitals. The 19th CPC National Congress held in 2017 proposed to strengthen the construction of primary care system and general practitioners team. There are few available studies on primary care physicians' satisfaction with work unit, job and career development in township hospitals.

To examine the relationships among work unit satisfaction, career development satisfaction and job satisfaction in primary care physicians working at township hospitals, providing scientific evidence for the construction of healthcare talent team in township hospitals.

This study was implemented from December 2019 to August 2020. By use of stratified multistage sampling, 1 736 physicians were selected from 193 township hospitals in 9 counties (districts) of Yulin, Baoji and Shangluo, three cities of Shaanxi to attend a questionnaire survey for understanding their basic demographics, work unit satisfaction, career development satisfaction and job satisfaction. SPSS AU and R were used for data analysis. Pearson correlation was used to analyze correlations among work unit satisfaction, job satisfaction and career development satisfaction. Hierarchical regression was used for mediation analysis. The mediating effect of job satisfaction was further tested by bootstrap test for product of coefficients.

Among the 1 736 cases, 1 727 (99.48%) who returned responsive questionnaires were included for final analysis. The average score of work unit satisfaction in the respondents was (2.03±0.52) points, and the average scores for its five dimensions (satisfaction with the overall management, the management system, welfare benefits, and development prospect, as well as the sense of identity obtained from the unit) were (1.94±0.93) , (2.55±1.21) , (2.17±0.73) , (1.91±0.80) , and (1.57±0.72) points, respectively. The average score of job satisfaction was (1.98±0.45) , and that of career development satisfaction was (2.42±0.49) . Pearson correlation analysis showed that career development satisfaction was positively correlated with work unit satisfaction and job satisfaction (P<0.05) . Hierarchical regression analysis revealed that job satisfaction played a mediating role in the relationship of satisfaction with welfare benefits, unit development prospect, and sense of identity obtained from the unit with career development satisfaction (P<0.05) . Further examination of mediation effect of job satisfaction showed that job satisfaction partially mediated in the relationship between satisfaction with welfare benefits and career development satisfaction (with an effect size of 0.020) , satisfaction with unit development prospect and career development satisfaction (with an effect size of 0.022) , or satisfaction with the sense of identity obtained from the unit and career development satisfaction (with an effect size of 0.012) (P<0.05) .

As job satisfaction plays a mediating role between work unit satisfaction and career development satisfaction in primary care physicians in township hospitals, it is suggested to improve their satisfaction with welfare benefits, unit development prospect and sense of identity obtained from the unit, to enhance their job satisfaction, thereby improving their career development satisfaction.

The program of targeted medical education program has been carried out since 2010 in China, aiming to train general medical talents working in primary care. Further research is needed to explore the working status and career planning in targeted admission medical graduates (TAMG) , as well as the overall assessment for them by the employing unit.

To comprehensively understand the working status (competencies, satisfaction, intention to improve professional capabilities) , career planning, retention intention and associated factors after fulfilling the preadmission commitments in TAMG working in Hainan's primary care after completing the "5+3" standardized general residency program, providing a basis for the optimization of incentive policies for training and retaining general practitioners (GPs) , and for medical colleges to determine the orientation and development direction of a general practice school (department) .

From April 25 to May 6, 2021, by use of cluster sampling, 615 GPs (including 309 TAMG trained with the "5+3" standardized general residency program who work as a GP in primary care after graduation, 56 assistant GPs trained with the "3+2" program, and 250 GPs trained with general medicine before shifting to the post) were selected from 19 cities (counties) in Hainan Province to attend a self-administered questionnaire survey for collecting information about their capabilities, satisfaction and intention to improve professional capabilities. At the same time, 1 574 leaders and colleagues of the TAMG were invited to evaluate the capabilities of the TAMG. The factors influencing the retention intention of the TAMG after fulfilling their preadmission commitments in primary care were analyzed by binary Logistic regression. For further understanding the working status, life and thoughts on the job of the TAMG, the offline research team of this study conducted field investigation in three primary hospitals (one in Haikou, one in Qiongzhong, and one in Sanya) , and held a group discussion with directors of health committees of Haikou, Qiongzhong and Sanya, and directors of the three primary hospitals, as well as 38 randomly selected TAMG from May 7 to 8, 2021.

TAMG had lower mean score of self-rated capabilities than assistant GPs trained with the "3+2" program〔 (19.31±2.59) vs (20.46±2.72) 〕, and GPs trained with general medicine before shifting to the post〔 (19.31±2.59) vs (20.77±2.73) 〕 (P<0.05) . TAMG had lower mean score of self-rated job satisfaction than assistant GPs trained with the "3+2" program〔 (39.77±4.66) vs (41.59±4.56) 〕, and GPs trained with general medicine before shifting to the post〔 (39.77±4.66) vs (41.10±5.19) 〕 (P<0.05) . TAMG had lower mean score of self-rated intention to improve professional capabilities than GPs trained with general medicine before shifting to the post〔 (7.80±2.25) vs (9.10±3.17) 〕 (P<0.05) . However, the mean score of capabilities of TAMG rated by TAMG' leaders and colleagues was higher than that rated by themselves〔 (20.29±3.43) vs (19.31±2.59) 〕 (t'=5.735, P<0.001) . One hundred and fourteen of TAMG (36.89%) intended to stay on after the expiration of the contract. The main factors affecting their retention intention were professional title, current income, and wanting to be a GP (P<0.05) . According to the group discussion, TAMG had high level of enthusiasm at their work and a great sense of team spirit. Moreover, more than half of them had a clear career plan. The challenges faced by TAMG in primary care were the following: overall low level of remuneration, unsatisfactory working environment, insufficient understanding and insufficient understanding and undervaluing of GPs and general practice in relevant administrative departments, inadequate implementation of relevant policies, and limited conditions in primary care hindering the acquisition of the latest advances in general medicine and continuing education.

The TAMG had high levels of capabilities and job statistician, but low level of intention to improve professional capabilities and to stay on after the expiration of the contract. Their capabilities were recognized by their leaders and colleagues. The implementation of incentive policies was un-ideal in Hainan, which may be due to satisfactory implementation of the incentive system for health talents in primary care. In view of this, it is suggested that relevant departments in Hainan take multiple measures collaboratively to effectively implement the incentive regimen of training and retaining GPs.

Graduate supervisors in general practice are responsible for the important task of training future general practice professionals, so their abilities to communicate with patients are essential for the development of general practice.

To examine the abilities to communicate with patients in supervisors of master's students in general practice during outpatient encounters.

Seventy-five supervisors of master's students in general practice from Capital Medical University were selected by use of cluster sampling to receive a survey using a self-developed demographic questionnaire conducted from April to June 2022. Then their doctor-patient communication skills during outpatient encounters were assessed by relevant professionals who participated in the whole encounter process as accompaniers using the SEGUE Framework. The total score and dimension scores of SEGUE Framework of these supervisors were compared with those of outpatient specialists in tertiary hospitals and general practitioners (GPs) in community health centers (CHCs) in our previous studies, and were compared across these supervisors by sex, employment method and level of medical institutions. Then the total score of SEGUE Framework was compared between the supervisors and US GPs.

The total score of SEGUE Framework attained by the supervisors ranged from 12 to 24 points, and the average score was (17.8±2.6) . The average scores of five dimensions (set the stage, elicit information, give information, understand the patient's perspective, and end the encounter) obtained by them were (3.9±0.9) , (6.5±1.7) , (3.1±1.1) , (2.6±0.9) and (1.7±0.5) , respectively. These supervisors scored higher on dimensions of set the stage and end the encounter than GPs in CHCs and outpatient specialists in tertiary hospitals (P<0.05) . Compared with their counterparts working in primary hospitals, supervisors working in secondary hospitals scored lower on the SEGUE Framework and set the stage dimension (P<0.05) , and those working in tertiary hospitals scored lower on the SEGUE Framework and set the stage and elicit information dimensions (P<0.05) . These supervisor scored lower on the SEGUE Framework than the US GPs (P<0.05) .

There is still considerable room for improvement of the skills for communicating with patients in outpatient encounters in these supervisors. Their level of communication skills was still lower than that of US GPs. In view of this, the teaching management department responsible for general practice department (school) should pay attention to the training of the abilities of master supervisors to communicate with patients, thereby improving the level of medical humanities in practice in master's students in general practice by supervisors' words and deeds.

Both the quantity and quality of general practitioners (GPs) are two important aspects in human resource management in healthcare, among which the increase, maintaining and loss of the number of GPs is an important indicator for assessing the dynamic planning, management and evaluation in human resource management for GPs, and also is an indicator for assessing the effectiveness of the standardized general practice residency program (SGPRP) . Studying the employment status and associated factors in trainees of the SGPRP will be references for the development of policies and incentives regarding the SGPRP. But there is a lack of such studies in non-targeted admission medical graduates completing the SGPRP.

To understand the employment status of non-targeted admission medical graduates finishing the SGPRP in Henan Province, and to identify the causes of choosing other careers instead of being a GP, providing a reference for the improvement of SGPRP management and incentive mechanisms for human resource management.

In August 2021, multistage random sampling was used to select non-targeted admission medical graduates (n=326) who had been admitted to the SGPRP during 2014 to 2017 and had completed it in Henan Province. They were invited to complete a self-administered survey questionnaire through the platform of wjx.cn for understanding their general information, and self-perceived status of training with SGPRP, current job, and causes of being a GP or choosing other careers.

The survey obtained a response rate of 83.1% (271/326) . Among the respondents, 77 (28.4%) chose GP as a career, and other 194 (71.6%) chose other careers after completing the SGPRP. Multivariate Logistic regression analysis showed that age, education level, type of source and the location of the general practice residency training base were associated with the career choice (P<0.05) . Compared with respondents with a non-GP career choice, those with a GP career choice had higher prevalence of having general practice as the registered major 〔70.1% (54/77) vs 32.0% (62/194) , P<0.05〕, and working at township health centers or community health centers〔49.4% (38/77) vs 6.2% (12/194) , P<0.05) 〕. Among those with a non-GP career choice, the top three careers were internal medicine practitioners〔40.2% (78/194) 〕, emergency and critical care practitioners〔17.0% (33/194) 〕, and surgical care practitioners〔8.8% (17/194) 〕. The three major causes of choosing a non-GP career were appointed by the employed hospital〔34.5% (67/194) 〕, lack of general practice department in the employed hospital〔29.9% (58/194) 〕 and low salary〔26.8% (52/194) 〕.

In these non-targeted admission medical graduates finishing the SGPRP, the prevalence of choosing a GP career was relatively low, which may be associated with age, education level, type of source, and the location of the general practice residency training base. To increase the attractiveness of GP as a career, it is recommended to expand the publicity of the concept of general medicine, accelerate the construction of the general practice department in general hospitals, and improve the salary of GPs.

With the changing disease spectrum of the population and the advancement of the national tiered diagnosis and treatment system, general practitioners play a vital role in disease diagnosis and treatment. At the same time, the continuous updating of medical knowledge and the ongoing changes in the health service demands of the residents necessitate the ongoing participation of general practitioners in continuing education and training. This ensures they can make the best diagnostic and treatment decisions and manage diseases effectively for their patients.

To analyze the current developments, training quality and research quality of continuing education research of general practice in China in the past ten years (2013-2022) .

In January 2023, eight Chinese and English databases including PubMed, Cochrane Library, Embase, CINAHL, ERIC, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and China Biology Medicine Literature Service System were used as data sources to obtain research on the training of continuing education for general practitioners in China. The literature was read, analyzed, organized, and summarized, with the search period ranging from January 2013 to December 2022. The Medical Education Research Study Quality Instrument (MERSQI) was utilized to comprehensively evaluate the quality of the literature.

This review included a total of 49 articles, of which 11 were in English and 38 in Chinese. The themes of continuing education training focused on cardiovascular and cerebrovascular diseases (22.4%), emergency-related content (6.1%), and mental health (6.1%). The training formats were relatively singular, mainly based on traditional expert lectures (69.3%), with only 6.1% adopting the form of skill training, and 4.0% of the studies using problem-based learning (PBL) or team-based learning (TBL) training formats. There was usually a lack of rigorous evaluation: 31 studies (63.2%) used questionnaires to assess the effectiveness of the training, of which 19 had not undergone validity and reliability testing. In the study design, the largest proportion was single-group pre-post comparison (53.1%), followed by randomized controlled trials with pre-post measurements (26.5%), and the smallest proportion was controlled pre-post comparison (4.1%). Only 9 studies (18.3%) explicitly mentioned ethical approval, while the majority of studies (81.7%) did not undergo ethical review. The evaluations focused on the enhancement of knowledge and skills of general practitioners before and after trainin (85.7%), with less coverage of actual behavioral changes (14.2%) and benefits to patients and healthcare facilities (22.4%) .

In the past decade, the attention to general practice continuing education research has been insufficient, but there is significant room for development. In the future, it is necessary to expand training themes and adopt diverse training methods based on actual needs. Utilizing assessment tools with good validity and reliability, and focusing on the actual behavioral changes brought about by training, will benefit patients and enhance the quality of continuing education for general practitioners in multiple dimensions.

Currently, there is a shortage of general practitioners (GPs) in primary care. Job transfer training is one of the main ways to train GPs and had important contributions to the construction of general practitioners team.

To analyze the job transfer operation of GPs in Xinjiang Uygur Autonomous Region from 2012 to 2020.

During December 2021 to March 2022, this study reviewed China Health Statistical Yearbook from 2013 to 2021 to obtain the data about GPs in Xinjiang from 2012 to 2020, reviewed trainees' lists of GPs job transfer training program from 2010 to 2022 organized by the Health Commission of Xinjiang Uygur Autonomous Region to obtain the real number of GPs transferred to training, and obtained the data about GPs distribution from the Science and Technology Education Department of the Health Commission of Xinjiang Uygur Autonomous Region.

There were 5 980 GPs in Xinjiang in 2020, and 1 765 (29.52%) of them were qualified GPs through the job transfer training. The gender and age distribution of job transfer training GPs in each prefectures of Xinjiang were statistically different (P<0.05) . According to the requirements of 3 qualified GPs per 10 000 residents, 6 696 GPs were needed in Xinjiang, and 7 254 GPs were needed in 2020, however, the fact is that the number of GPs in Xinjiang increased from 1 925 (0.86 per 10 000 residents) in 2012 to 5 980 (2.47 per 10 000 residents) in 2020. The proportion of GPs through job transfer training gradually decreased from 35.84% (690/1 925) in 2012 to 1.07% (64/5 980) in 2020. The largest number of assigned GPs through job transfer training is 293 in 2012, and the smallest number is 11 in 2017. From 2012 to 2020, Kashgar area had the most assigned GPs of 248, Karamay city had the least assigned GPs of 4.

Job transfer training made an important contribution to the training of GPs. With the implementation of various policies, we reached the target of every 10 000 people, but the total number of GPs has not yet reached 7 000. Therefore, there is still a shortage of GPs. We should strengthen the implementation of relevant policies and encourage clinicians to participate in the transfer training of GPs.

Community-based clinical teaching is of vital importance in the training of medical undergraduates, but high level of effectiveness of teaching is difficult to be guaranteed at present. So it is essential to establish a scientific and effective system for assessing the effectiveness of community-based clinical teaching for medical undergraduates.

To develop an effectiveness assessment system of community-based clinical teaching for medical undergraduates, providing support for assessing the effectiveness of community-based clinical teaching in these undergraduates.

The item pool for the system used for assessing the effectiveness of community-based clinical teaching in medical undergraduates was developed on the basis of reviewing relevant literature and assessment tools, and was drawn up by group discussions. Then the items were improved according to two rounds of Delphi consultation with a purposive sample of 32 relevant experts from June 2019 to April 2020, and used to develop the Effectiveness Assessment System of Community-based Clinical Teaching for Medical Undergraduates (EASCCTMU) . The Analytic Hierarchy Process was used to calculate the weight of each indicator.

The response rate was 100.0% for both rounds of consultation. The authoritative coefficients for the first and second rounds of consultation were 0.87 and 0.88, respectively. The Kendall's coefficient of concordance for the first and second rounds of consultation were 0.65 and 0.61, respectively (P<0.01) . The final system contains 4 first-level indicators (clinical thinking skills, public health preparedness capability, medical humanistic beliefs, and community-based teaching feelings with corresponding weights of 0.456 1, 0.242 5, 0.283 2 and 0.305 1) and 26 second-level indicators.

The EASCCTMU is highly scientific and operable, which could be used for comprehensively and objectively assessing the effectiveness of community-based clinical teaching in medical undergraduates. However, it still needs to be improved by empirical research.

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.

Family doctors play a major role in the construction of the family doctor system, one of the five basic projects in Shanghai launched since April 2011, so understanding their confidence level regarding practice is crucial to the promotion of high-quality development of family doctor system in China.

To investigate the family doctor confidence index (FDCI) in 2020 and its trend from 2014 to 2020 among general practitioners (GPs) in Pudong New Area of Shanghai, and to predict their future 3-year FDCI, providing insights into the promotion of the construction of family doctor system.

Participants were incumbent GPs who provided family care services in 9 community health centers in Pudong New Area of Shanghai, the settings in which the 2014 FDCI survey in Shanghai's Pudong New Area was conducted. They were invited to attend an online survey through the platform of www.wjx.cn in December 2020 using a questionnaire developed by ourselves based on the implementation of family doctor system in Pudong New Area, the contents of E2-E3 pages of the original China Medical Tribune·General Practice Weekly published on June 22, 2017, and the survey contents of FDCI developed by GU Yuan Family Doctor Studio. FDCI was compared by demographic indices. The future 3-year FDCI was estimated overall, and compared across GPs by demographic indices. The trend of FDCI between 2014 and 2020 was analyzed.

A total of 350 cases attended the survey, and 347 of them (99.1%) who returned were responsive questionnaires were included for analysis. The average FDCI of the participants was (51.96±28.42) in 2020, and that predicted for 2023 was (54.03±26.56) , showing no significant difference (P>0.05) . In 2020, GPs working at rural areas had higher FDCI than those working at urban and peri-urban areas (P<0.05) ; Those who became a GP after training prior to the post shift had higher FDCI than those who became a GP after standardized residency training or passing the professional title examination (P<0.05) ; GPs with junior college education or below had higher FDCI than those with a bachelor/master degree or above (P<0.05) ; GPs who held a concurrent administrative post or handled administrative matters in their hospital had higher FDCI than those did not (P<0.05) . Higher FDCI predicted for 2023 was found in those with working at rural areas instead of those working at urban and peri-urban areas, and in those with junior college education or below instead of those with a bachelor /master degree or above (P<0.05) . Those who were male, aged 23-29, worked at urban area, had an experience of≤1 or>5 years of working as a family doctor, had a bachelor degree or intermediate professional title were predicted to have higher FDCI in 2023 than in 2020 (P<0.05) . The overall FDCI in 2020 was higher than that in 2014〔 (51.96±28.42) vs (24.65±22.75) 〕and 2017〔 (51.96±28.42) vs (48.20±23.10) 〕, with statistical significance (P<0.05) .

The overall FDCI of GPs in Shanghai's Pudong New Area in 2020 and that predicted for 2023 was moderate, and the overall FDCI in 2020 was significantly higher than that in 2014 and 2017. The present and future 3-year FDCI varied among GPs by demographic characteristics. GPs were fully confident in the future development of the industry and their own occupation, and needed continuous policy and social supports.

The competency in primary performance positions of rural order-oriented medical graduates of standardized general residency training program (abbreviate for oriented general practitioners) has attracted wide attention. Strengthening continuing medical education is an important measure to enhance the competency of oriented general practitioners.

To understand the current situation, problems and needs of continuing medical education for oriented general practitioners in Guizhou Province, and to provide a basis for improving continuing medical education for oriented general practitioners.

From November to December 2021, 42 oriented general practitioners from 39 township hospitals in 9 cities in Guizhou Province were selected as the research subjects for semi-structured interviews by the purposive sampling and snowball sampling methods. The interview results were coded and analyzed by the research method of procedural grounded theory to extract and summarize the current situation, problems and needs of their continuing medical education.

After three-level coding, 145 concepts, 23 categories and 5 domains related to the continuing medical education of oriented general practitioners were finally sorted out, and a story line was consequenty formed: the continuing medical education of oriented general practitioners is influenced by several factors, among which actual situation is the obstacle, competency requirement is the extrinsic driver, policy system is important guarantee, self-demand is the intrinsic motivation, and the improvement of the training process management is the key process.

The training intention of oriented general practitioners remains to be strengthened in Guizhou Province. The quality of continuing medical education, integration degree of training content and demand, and attention of primary care institutions need to be improved. The support for continuing medical education and the construction of information platform should be strengthened, and the content and form of continuing medical education suitable for oriented general practitioners should be improved, in order to improve the quality and effect of training in continuing medical education.

Teaching objectives are the soul and pillar of teaching activity and closely related to class teaching effects. Currently, the cognition and formulation of faculty teaching objectives in standardized training for residency practitioners (abbreviated as general practice residency) has been rarely reported at present.

To understand the cognition, formulation basis, construction and writing of teaching objectives among outstanding teachers of general practice in China, so as to discuss the approaches of teachers to better promote teaching through teaching objectives in the general practice residency during the process of developing general practice residency, which is highly specialized, focused on post competency development, and different from institutional education.

The outstanding general practice teachers with the title of associate chief physician and above and related teaching honors on a college level or above, who have been teaching in general practice residency for 5 years or more and are still involved in teaching visits and developing teaching objectives in their teaching activities were selected as research subjects from the general practice departments of national general practice residency base in the hospitals affiliated with well-known medical colleges located in the regions with high development level of general practice. One-to-one semi-structured in-depth interview was conducted by online video conference from February to June 2022. The thematic framework analysis was used to organize and analyze the data and to refine the interview themes through NVivo 12 software.

A total of 8 general practice teachers were enrolled. Through the analysis of the interview data, a total of 3 themes and 4 sub-themes were extracted, including that general practice teachers can better grasp the establishment principles of teaching objectives; there is a lack of institutional guarantees in the construction of teaching objectives, involving 2 sub-themes of the lack of theoretical foundation and normative environment for the construction of teaching objectives; general practice teachers have insufficient cognition of the role of teaching objectives in the development of post competency, involving 2 sub-themes of cognitive deficiencies in teaching objectives, little significance of teaching objectives in guiding teaching activities.

There are still problems in the recognition and formulation of teaching objectives even among the outstanding general practice teachers, which may affect the teaching effects. It is necessary to focus on and ensure the effective formulation of teaching objectives and enhance relevant theoretical training. The teaching objectives should be taken as a starting point to promote the homogeneous development and construction of general practice teachers, so as to train more qualified general practitioners.

The design and implementation of county continuing professional development and training model for general practitioners is the core of the collaboration on continuing professional development of general practice between the Department of General Practice of Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine and Deqing County of Zhejiang Province. This article introduces the design and implementation of the "hierarchical progressive" continuing professional development training model in the collaboration framework in detail, shares a information platform by virtue of high-quality resources of general practice department of the general hospital, develops the county-level professional development training model for general practitioners, providing reference for colleagues.

With the strong support of national and local policies, the construction of general practice education system and personnel training have been developed in Guangdong Province for nearly 30 years. Since 1996, general practice education in Guangdong Province has gone through four stages, including exploration and start, vigorous growth, development and perfection, comprehensive development. Colleges and universities in Guangdong Province, represented by Guangzhou Medical University, have explored and established a multi-level, multi-path, multi-form and multi-objective general practice education system of treatment-prevention integration, with interconnected academy education, job-transfer training, standardized training, postgraduate education and continuing education, and a standardized training model of general practitioners based on "5+3" has been basically established. The pass rate of the provincial training certificate examination of general practice training students has reached more than 85%. In 2020, there were 4 general practitioners per 10 000 residents, meeting the national requirement of 3 general practitioners per 10 000 residents in 2020. With the purpose to analyze the current situation of the development of general practice education in Guangdong Province, this paper comprehensively summarized the experience and lessons of discipline construction and education training of general practice, broadened the paths and modes of the quality of general practice personnel training, put forward relevant suggestions, to provide policy ideas and reference basis for the rapid development of general practice education in Guangdong Province and even in China in the future.

In order to change the shortage of general practitioners in primary care, China has been implementing a rural order-oriented medical student training program in 2010. Currently, the overall performance intention, performance situation and retention intention of order-oriented medical students in China still remains unclear and need to be supported by more reliable evidence.

To systematically evaluate the performance intention rate, actual performance rate and retention intention rate of order-oriented medical students in China and analyze its influencing factors.

From January to June 2022, CNKI, Wanfang Data, VIP, PubMed and Embase databases were searched to collect literature related to service intention, performance intention and retention intention for primary care of order-oriented medical students in China with a time period from 2010 to 2021, and the language of the literature was limited to Chinese and English. Two investigators independently screened literature and extracted data independently to evaluate the risk of bias of the included studies. Meta-analysis of single-group rates was performed using RevMan 5.4 software.

A total of 49 papers were included with a survey period of 2010-2020, involving 22 413 order-oriented medical students. The performance intention rate of order-oriented medical students was 62% [95%CI (55%-69%) ], the performance rate was 95% [95%CI (93%-96%) ], the retention intention rate was 16% [95%CI (13%-19%) ]. The results of subgroup analysis showed that the performance intention rate of the literature published in 2011 [90%, 95%CI (84%-96%) ] was higher than the other years (P<0.01), the performance intention rate was higher in North China [87%, 95%CI (84%-90%) ] than the other regions, the performance intention rate of college students [68%, 95%CI (67%-69%) ] was higher than the residents in standardization training (P<0.01) ; the performance rate of the published literature in 2020 [99%, 95%CI (99%-100%) ] was higher than the other years (P<0.01), and the performance rate [100%, 95%CI (99%-100%) ] in Central China was higher than the other regions (P<0.01) ; the retention intention rate of the literature published in 2015 [36%, 95%CI (2%-70%) ] was higher than the other years (P<0.01), the retention intention rate [23%, 95%CI (4%-41%) ] was higher in South China than the other regions (P<0.01), the retention intention rate of the college students [18%, 95%CI (13%-22%) ] was higher than the residents in standardization training and primary care providers performing contracts (P<0.01) .

The actual performance rate of order-oriented medical students in China is high, but the performance intention rate and retention intention rate are low. Region, time and medical education stage are the influencing factors.

The emergence of virtual reality (VR) technology is the breakthrough of medical education reform. It is the focus of clinical educators to apply VR technology to medical education and discuss the application effect. The application of VR in the standardized training of residents (referred to as residential training) is not rare, but the literature on the application of VR in the residential training of general practice has not been reported.

To explore the effectiveness of VR technology in the residential training of general practice, and provide a reference for the promotion and application of VR technology in the residential training of general practice.

From May 16, 2022 to August 16, 2022, a total of 58 general practitioners in the grade of 2020 in the Department of General Practice in the First Affiliated Hospital of Zhengzhou University, Henan Province were selected as the research objects and divided into the experimental group (n=29) and control group (n=29) by using random number generator. The experimental group adopted the teaching method of combining traditional theoretical training and VR skills training, and the control group adopted the method of combining traditional theoretical training and traditional skills training. The training content included the first aid of cardiopulmonary resuscitation and electric defibrillation, the treatment process of organophosphorus poisoning, and treatment process of independent sudden dyspnea in the hospital. Questionnaires were distributed to investigate the basic information of the subjects and their understanding of VR before the training, theoretical and skill assessments were carried out respectively after training, and the two groups of residents were compared in theoretical assessment results, skill assessment results, self-assessment results of the key points of training skills and satisfaction with teaching methods.

There was no difference in gender, age and years of graduation between the experimental group and control group (P>0.05). After training, the theoretical and skill assessment scores of the experimental group were higher than those of the control group (P<0.05). With an assessment score ≥80 as excellence in assessment, the excellent rate of theoretical assessment in the experimental group was higher than the control group (P<0.05). The self-assessed rate of mastery of the key points of the first aid skills for electric defibrillation and organophosphorus poisoning in the experimental group was higher than the control group (P<0.05). The satisfaction scores of study interest, self-study ability, clinical thinking and judgment ability, clinical comprehensive ability, simulation of clinical environment, improvement of teaching effect, preparation for clinical practice and whether teaching is helpful to them were all higher than those of the control group (P<0.05) .

Compared with the traditional teaching mode, the application of traditional theoretical training combined with VR skills training teaching method is conducive to improving their mastery of professional knowledge, which has popularization value in the teaching of residential training of general practice.

Whole-course management refers to a patient-centered care model over the entire course of patients, aimed at patients' satisfaction with medical care, improving the whole course management of the disease. The whole-course management model has achieved significant success in various medical fields, such as the treatment of mental health disorders. However, its application in the general practitioner training has been rarely studied.

To investigate the practical effectiveness of the whole-course management teaching model in standardized training for general practitioners.

A total of 60 general practitioners of grades 2020, 2021 and 2022 who received national standardized training at Xiangya Second Hospital of Central South University. Additionally, 30 mentors specializing in total disease management were selected, with each mentor supervising two general practitioners, one from the research group and one from the control group, in order to minimize the impact of personal factors of mentors and ensure more objective research results. All levels of general practitioners of grades 2020, 2021 and 2022 were randomly divided into the research and control groups. The research group adopted whole-course management teaching mode while the control group followed the traditional lecture-based learning (LBL) model, with one team leader selected from each grade. After a nine-month training period (July 2022 to March 2023) , participants were evaluated on 6 items of diagnostic capability, treatment effect evaluation, patient management ability, teamwork ability, self-learning capability, and teaching ability. Simultaneously, a self-designed satisfaction questionnaire was also used to investigate patients under the care of these general practitioners. The average score was calculated based on ratings from three patients per general practitioner.

Diagnostic capability, patient management ability, self-learning capability, and teaching ability scores of grade 2020 in the research group were high than those of the control group (P<0.05) ; diagnostic capability, teamwork ability, self-learning capability and teaching ability scores of grade 2021 in the research group were high than those of the control group (P<0.05) ; the research group of grade 2022 achieved higher scores than the control group in diagnostic capability, patient management ability, teamwork ability, self-learning capability, and teaching ability, with statistically significant differences (P<0.05) . The research groups of grades 2020 and 2021 received higher patient satisfaction scores than the control group in various aspects, including communication style, privacy protection, formulation of diagnosis and treatment plan/examination of patients informed, explaining and educating before operation or administration, treatment effectiveness and operation skills, addressing patients' inquiries patiently, responsibility/service attitude, integrity in medical practice, medical fairness, and discharge guidance satisfaction, with statistically significant differences (P<0.05) . The research groups of grade 2022 received higher patient satisfaction scores than the control group in communication style, privacy protection, formulation of diagnosis and treatment plan/examination of patients informed, explaining and educating before operation or administration, treatment effectiveness and operation skills, addressing patients' inquiries patiently, responsibility/service attitude, integrity in medical practice, etiquette dress code and discharge guidance, with statistically significant differences (P<0.05) .

The whole-course management teaching model demonstrated advantages in enhancing the diagnostic capabilities, patient management ability, teamwork ability, self-learning capability, and teaching ability of general practitioners. Additionally, patients expressed higher satisfaction with general practitioners trained in whole-course management teaching mode in terms of communication style, privacy protection, formulation of diagnosis and treatment plan/examination of patients informed, explaining and educating before operation or administration, treatment effectiveness and operation skills, addressing patients' inquiries patiently, responsibility/service attitude, integrity in medical practice and discharge guidance.