The development of excellent general practitioners is essential to preserving people's health. Unfortunately, the general practitioner training model in place today is insufficient, which leaves them unqualified to provide primary medical services. Consequently, enhancing clinical competency should be the main goal of general practitioners' training.

To investigate how general practitioners' clinical practice abilities are affected by MDT-based CBL education.

From July 2020 to July 2023, 26 trainee general practitioners received training at the department of pulmonary and critical care medicine as part of their residency programme. As research subjects, they were divided three groups and trained with different model: traditional model, CBL model and MDT-based CBL model, respectively. Leicester Assessment Package (LAP) was used to assess their clinical practice skills by the end. Self-designed questionnaire was used for satisfaction survey anonymously. The results were analyzed statistically.

The MDT-based CBL teaching group outperformed the traditional teaching group and the CBL teaching group in the theoretical examination (P<0.05). The MDT-based CBL teaching group had a significantly higher total LAP score (P<0.05) in comparison to either the conventional teaching group or CBL teaching group. Further investigation revealed that the MDT-based CBL teaching group performed better (P<0.05) in the part of patient admissions, collecting medical histories, patient management, problem solving, physician behavior, patient relationship, and preventive therapy. The students from the MDT-based CBL model had the best overall satisfaction, with a significant difference comparing the students from the CBL and traditional teaching groups (P<0.05). Additionally, the MDT-based CBL teaching group showed a significant improvement in their capacity to guide healthy lifestyle, deal with commodities, guide patient recovery, and use medications after discharge (P<0.05) .

A novel training approach for general practitioner, the MDT-based CBL teaching mode may enhance the clinical practice abilities and competency of general practitioners.

The implementation of standardized teaching clinic activities by the faculty of standardized training of general practice residents (hereinafter referred to as residency training) is a key link in the cultivation of qualified general practitioners. And in July 2021, the Chinese Physicians' Association organized experts to revise the Specification for General Practice Teaching Clinic for Standardized Training of Residents in the Specialty of General Practice (for Trial Implementation), which is referenced by all the residency training bases of general practice across the country to carry out the teaching clinic. However, at this stage, the implementation of teaching clinic in each residency training base is still in the exploratory stage, and the degree of attention is insufficient, and the phenomenon of low quality and irregularity in the form of teaching clinic prevails.

To understand the current situation and influencing factors on the willingness of general practice residency faculty to conduct teaching clinics, not only to analyze the difficulties and confusions in conducting teaching clinics, but also provide reflections and recommendations.

From October 2021 to November 2023, a survey was conducted among general practitioners who participated in the provincial-level general practice residency training programs for regular and key instructors in Guangdong Province. A self-designed questionnaire was used to collect data from the included instructors, covering their basic information, work situation, and their willingness to teach. The electronic questionnaire was created using the "Questionnaire Star" platform, which also facilitated the online distribution and collection of the survey.

The average age of general practice faculty was (40.7±14.1) years, 724 (72.18%) faculty members' institutions had general practice teaching clinics, 792 (78.96%) had a desire to teach, 710 (70.79%) had no experience in teaching, 904 (90.13%) had self-assessed their competence in teaching as a score of 60-89, and 583 (58.13%) had received no general practice teaching clinic faculty training, 462 (46.06%) expected faculty training to be conducted in the form of a combination of multiple types of training, 417 (41.58%) and 309 (30.81%), respectively, believed that the teaching difficulty of general practice teaching clinics was to instruct general practice residents to independently receive patients in the general practice clinic and to teach in a tiered manner, and 377 (37.59%) believed that the most difficult teaching objective to achieve was to instruct general practice residents in general practice clinical thinking and improve their clinical decision-making skills, 216 (21.54%) believed that the most needed training component for general practice residents was consultation skills, and 456 (45.46%) believed that the reason their institution did not/would not conduct a teaching clinic was lack of time. Also, the results of the multifactorial logistic regression analysis showed that the availability of general practice teaching clinics at the institution where they are located, experience in teaching, self-assessment of teaching competence, and acceptance of faculty training in general practice teaching clinics were the factors influencing the willingness to teach in general practice faculty teaching clinics (P<0.05) .

Most of the general practice resident training faculty are willing to carry out general practice teaching clinics, but there are difficulties such as insufficient experience in teaching, training in teaching, and ability in teaching. So it is recommended to optimize and standardize general practice teaching clinics, strengthen the training of general practice concepts for general practice teaching clinic faculty, strengthen incentives for teaching, and improve the monitoring and feedback mechanism for resident faculty in order to improve the quality of general practice teaching clinics.

As an important part of the general practice team, assistant general practitioners undertake a lot of grassroots general practice work, but at present, there is no recognized national level assistant general practitioners post competency model to provide scientific basis for training qualified assistant general practitioners.

The competency of assistant general practitioners for China was constructed to provide support for the design of national assistant physician qualification examination, and provide theoretical basis for the training and evaluation of assistant general practitioners.

Based on the research group's previous literature research and behavioral event interviews, from September 2019 to January 2020, the entry pool was established, and 30 experts engaged in general practice were consulted by Delphi method for 2 rounds. The index and weight coefficient of the Chinese assistant general practitioner post competency model were determined by AHP.

Six first-level indicators [the basic medical and health services (0.244 8), medical knowledge and life-long learning (0.244 8), and professional quality (0.244 8), interpersonal communication and team work (0.138 9), the basic public health services (0.085 8), the information utilization ability and management capacity (0.041 0) ] and 63 second-level indicators were finalized, and the weight coefficients of each indicator were defined.

This study constructs the post competency of assistant general practitioners for China for the first time, which has a high degree of expert representativeness and authority, and a more comprehensive and reasonable index selection, laying a foundation for the empirical study of the index system.

Games are an emerging pedagogical tool in medical education, and they are recognized as a potentially attractive form of complementary learning. Research on the application of games in medical education has gradually increased in recent years, but the development of related research in China has been slow. Reviewing the research literature related to the use of games in medical education and gaining a comprehensive understanding of the current status and hotspots of the development of this field will be conducive to promoting the development of the research field of medical education in China.

To analyze the current status of the research on the application of games to medical education, and to provide reference and information for future research related to the application of games to medical education.

From February to April in 2023, with the help of CiteSpace 6.1R6 and Microsoft Excel 2019 software, we searched the relevant literature from Web of Science Core Collection database (WoSCC) from 2013-01-01 to 2023-02-26 with the theme of "game" and "medical education", and analyzed the number of publications, authors, countries/institutions, and the number of articles.

Finally, 652 English-language articles were included. There was a general upward trend in the number of publications in the last 11 years, with the United States being the top country in terms of the number of publications (201), centrality (0.48), and the annual number of publications, and Canada (67, centrality 0.15) and the United Kingdom (56, centrality 0.47) in the second and third places, respectively. The University of Toronto, Canada was the institution with the highest total number of articles with 21 articles. High-frequency keywords included medical education, education, serious games, simulation, and performance. The keyword with the highest level of emergence in the keyword emergence analysis was serious games (emergence intensity 3.4) .

Currently, the application of games in medical education has attracted more and more attention from scholars, and the research hotspots mainly focus on the role played by different games in the process of talent cultivation, but there is no high-quality evidence to provide educators with evidence-based recommendations. China still needs further exploration in this field, and educators need to apply more in the teaching process to better validate its effectiveness and promote the development of medical education.

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.

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.

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.

With the continuous development of the training program of rural order-oriented medical students (referred to as publicly-funded medical students) in China, the talent team of general practice is constantly enriched, and the professional identity status and its influencing factors in rural order-oriented medical students have become the focus of current attention.

To analyze the influencing factors of professional identity in rural order-oriented medical students.

Purposive sampling method was used to interview the 30 rural order-oriented medical students from 2018 to 2022 grade of Traditional Chinese Medicine (five-year system) Beneficiary Class of Shandong University of Traditional Chinese Medicine by semi-structured interviews from December 2022 to March 2023. The interview data were coded and analyzed by using open coding, axial coding, and selective coding, following the Anselm Strauss and Juliet Corbin programmatic grounded theory approach.

A total of 482 initial concepts and 47 basic categories were extracted by open coding, 9 main categories obtained by axial coding. A typical relationship structure was formed by selective coding, and it showed that the influencing factors of professional identity in rural order-oriented medical students were consisted with six dimensions of career cognition, career behavior, career choice, career will, career emotion, and career belief.

The influencing factors of professional identity in rural order-oriented medical students are composed of six dimensions, including career cognition, career behavior, career choice, career will, career emotion, and career belief, of which career cognition, career behavior, and career choice belong to the exogenous factors, while career will, career belief, and career emotion belong to the implicit factors.

China's National Compulsory Service Programme (CSP) is an important measure to alleviate its shortage of primary health care (PHC) workforce and improve quality of care in rural areas. Currently, the work status and turnover intention of the CSP medical graduates (the fully-fledged general practitioners in China) have received considerable attention.

This article will investigate the medical graduates' workplace violence, burnout, and turnover intention, in order to provide policy recommendations to stabilize the general practitioners.

From December 2021 to February 2022, an online structural questionnaire survey was conducted in nine out of 22 provinces adopting a stratified random sampling method. The electronic questionnaires were distributed to medical graduates with the assistance of the Science and Education Department of the Provincial Health Commission. The burnout of medical graduates was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) . Workplace violence involved the verbal and physical violence. Turnover intention was measured by "Are you willing to continue serving at the PHC institutions upon the completion of the contract (the compulsory service) ?" Multivariate Logistic regression analysis was used to explore the impact of burnout and workplace violence on turnover intention.

A total of 3 615 questionnaires were effectively collected. 87.77% (3 173/3 615) of medical graduates were unwilling or unsure to continue their employment after finishing the contract. 17.46% (631/3 615) of medical graduates had experienced physical violence, and 60.33% (2 181/3 615) had experienced verbal violence. In addition, the detection rate of burnout was 55.82% (2 018/3615) , of which 60.80% (2 198/3 615) were in moderate or severe emotional exhaustion, while the proportions of depersonalization and personal accomplishment were 67.55% (2 442/3 615) and 83.76% (3 028/3 615) , respectively. Logistic regression analysis showed that after controlling for socio-economic factors such as gender, professional title, and personal monthly income, medical graduates who were experiencing burnout had a 4.92 times[95%CI (3.87-6.25) ] higher risk of leaving, a 1.92[95%CI (1.50-2.46) ]times higher risk of uncertain retention (P<0.05) . Medical graduates who experienced verbal and physical violence were 1.46 times[95%CI (1.12-1.91) ] and 0.38 times[95%CI (0.27-0.52) ] more likely to leave after the contract expires (P<0.05) .

Medical graduates have a high intention to leave, and it is expected that there will be a significant loss of general practitioners after the contract expires. Burnout is a significant and prevalent problem affecting turnover intention. Efforts should be made from multiple perspectives to alleviate medical graduates' negative emotions, and thus stabilize the general practitioners.

In 2010, China began to implement a free training program for rural order-oriented medical students (the "program") , which has played an important role in improving the construction of grass-roots health personnel and upgrading the level of grass-roots medical and health services. As the program has progressed, despite certain successes, there are many problems that remain to be solved, and it is not yet known which are the urgent and important core issues.

Sorting out the problems with the program to provide lessons learned for moving the program forward.

In May 2023, Chinese databases were searched using the literature analysis method to sort out the problems of the project documented in the literature; the problems resulting from the sorting out were analyzed using the social network analysis method, and the results calculated based on the social network analysis method were comprehensively evaluated using the TOPSIS method.

The relevant problems in the literature were organized and counted. The top-ranked problems in order of frequency were low salary and treatment at the grassroots level for oriented medical students (14 times) , limited space for career development at the grassroots level for oriented medical students (10 times) , imperfect relevant supporting policies (10 times) , poor working conditions at the grassroots level (7 times) , and lack of motivation and initiative in learning for oriented medical students (7 times) ; and the results of the social network analysis were synthesized and evaluated by the TOPSIS method. The results of the social network analysis method were comprehensively evaluated by the TOPSIS method, and the top four rankings were imperfect relevant supporting policies (C_i=0.867) , limited space for grassroots career development of oriented medical students (C_i=0.800) , low grassroots salary and treatment of oriented medical students (C_i=0.786) , and poor grassroots working conditions (C_i=0.621) in the order of ranking.

Guangxi's free training program for rural order-oriented medical students still has major problems in the process of promoting the program. It is recommended that the program be optimized in the following ways to ensure its high-quality development: improve relevant supporting policies and strengthen supervision and evaluation; smooth career promotion channels and establish a long-term incentive mechanism; improve the remuneration system and raise the level of treatment; and improve the grass-roots working environment to enhance the quality of grass-roots work and increase efficiency.

Competency development is the core of residency training in general practice, as well as the key to training qualified general practitioners. Summative assessment can evaluate overall training outcome and the attainment of general practitioner competencies. Summative assessment in general practice is still in developing in China, and its relevance to competencies is relatively weak.

To develop competency based summative assessment indicator framework of residency training in general practice, and to provide reference for improving the summative assessment system in China.

From 2023-04-25 to 30, 32 experts from 10 provinces, including Beijing, Shanghai, Hebei, Jiangsu, Zhejiang, Liaoning, Inner Mongolia Autonomous Region, Hainan, Ningxia Hui Autonomous Region and Sichuan Province were invited to participate in Delphi Expert Survey. The indicator framework of summative assessment was established through literature review and Delphi expert survey. The weight of indicators was determined by multiplicative model.

In both the first and second rounds of expert survey, 32 questionnaires were issued and 32 were recovered, which were all valid. The positive coefficient was 100.0%, the authority coefficient was > 0.8, the importance coordination coefficient of indicators at all levels respectively was 0.382, 0.284, 0.265, and the feasibility coordination coefficient was 0.415, 0.359, 0.332. The final summative assessment indicator framework consisted of 6 first-tier indicators, 24 second-tier indicators and 50 third-tier indicators. The first-tier indicators include application of clinical professional knowledge and skills, the ability to take care of the family, the ability to provide basic public health services, the ability to communicate, cooperate and coordinate, humanistic ability and professionalism, clinical teaching and scientific research ability, and the weights were 0.505, 0.061, 0.109, 0.134, 0.125 and 0.066, respectively.

This study preliminarily explored and constructed competency based summative assessment indicator framework of residency training in general practice, which provides reference for further research on the contents of summative assessment and on the improvement of summative assessment system in China. The framework is important for improving the quality of residency training and competencies of general practitioners.

In outpatient clinics, physicians serve as the primary providers of medical treatment activities; their positive attitudes and effective patient-physician communication methods are essential for guaranteeing high-quality healthcare services.

To compare the outpatient doctor's emotional state and completion of communication details between outpatient doctor's experiential communication and GLTC communication. To provide a reference for improving a doctor's communication skills and emotional state in the future.

From July 2021 to January 2022, 24 outpatient doctors from 6 departments in 4 tertiary general hospitals in Nanjing, Jiangsu Province were randomly selected as the research objects. Outpatient doctor-patient communication scenes meeting the criteria were selected as observation scenes. All of the included outpatient doctors in the same cohort underwent an individual experiential communication program first (recorded as the experiential group). Next, they received training on the outpatient GLTC doctor-patient communication program. Finally, the doctors conducted outpatient GLTC communication one week later (recorded as the GLTC group). The experiential group and the GLTC group were compared in terms of the Brief Profile of Mood States (BPOMS) score before and after communication as well as the completion rate of communication details.

The fatigue dimension score of BPOMS after communication was higher than that before communication in the experiential group (P<0.05) ; After communication, The fatigue and confusion dimension score of BPOMS in the GLTC group were lower than the experiential group (P<0.05) ; the completion rate of communication details in the GLTC group such as kind gaze (reception), polite language (reception), smile (reception), not easily interrupting patients, timely nodding response, appeasement, informing the necessity, patience (experimental examination), consulting patients' opinions, patience (diagnosis and communication), popular explanation, language comfort, friendly attitude, getting up (ending and explaining), kind gaze (ending and explaining), polite language (ending and explanation), smile (ending and explanation) was higher than the experiential group (P<0.05) .

Compared with experiential communication, GLTC communication is more capable of improving doctors' emotional state and relieving doctors' fatigue. At the same time, the completion rate of the corresponding communication details is improved, but there is still room for improvement in the completion rate of some communication details.

In standardized residency training for general practice trainees, the rotation time in various clinical specialties is short, and there is a wide range of learning content, requiring enhanced learning autonomy. General practice faculty would be dealing with trainees from a variety of backgrounds, including 5+3, transfer, professional masters, or 3+2 assistant general practitioners, interns, public health trainees. It was necessary to study how to enable different training targets to get what they need and achieve the desired training effect in training needed to be carefully studied.

The objective of this study was to explore a training method that addresses structural problems, enhances trainees' learning initiative, and cultivates their ability for deeper thinking.

At the end of each learning activity, immediate discussions were organized to address the following questions: "1. What have you learned through the study? 2. What other questions do you have? 3. What are the same or similar experiences that you can share with others? 4. What inspirations do you have for future work?" The paper conducted theoretical analyses of the four questions to elucidate the method's internal logic and trainees' thinking process. Corresponding questionnaires were designed for validation studies conducted in the General Practice Backbone Teachers' Training Class and the Grassroots Talent Class.

The training method received strong agreement from the trainees, with the composite score ranging between "strongly agreed" and "agreed". After conducting parameter tests, no statistical differences were found in the answers concerning gender, age, title, position, and working experience. However, statistical differences were observed in academic qualifications, work units, and participated training programs (P<0.05) .

The use of structural problems with progressive meanings and a flexible training format proved effective in stimulating deeper thinking among trainees. The higher level of acceptance observed in the Grassroots Talent Class suggested that the method was particularly applicable to primary general practitioners and can enhance their ability for deeper thinking.

The phase of undergraduate medical education is the starting point for fostering communication competence of students in Rural-oriented Free Tuition Medical Education Program (RTME), which lays the foundation both for communication competence training in the postgraduate education phase and performing effective communications with patients and their relatives, colleagues, and other health personnel in the career life of general practitioners (GPs). It is of great practical significance to explore how to improve quality of doctor-patient communication education in the stage of undergraduate medical education and develop doctor-patient communication competence of the RTME students.

To explore the role of the ladderlike communication skill course on fostering doctor-patient communication competence of students in rural-oriented free tuition medical education program.

A total of 259 RTME students of Grade 2019 were selected from Guangxi Medical University in September 2019 to establish Cohort 1, and 262 undergraduate medical students of Grade 2019 were selected to establish Cohort 2. From September 2019 to January 2022, the students in Cohort 1 were trained in a ladderlike communication skill course lasting for five consecutive semesters; from September 2021 to January 2022, the students in both cohorts were trained in a doctor-patient communication course. The final exam scores and process assessment scores of the two cohorts on the doctor-patient communication course were compared and the evaluation of teaching effectiveness and satisfaction of ladderlike communication skill course were investigated in the students in Cohort 1.

The RTME students achieved significantly greater total scores for the final exam of the doctor-patient communication course, in which the RTME students performed better on the sections of case analysis and small essay, but worse on the single-choice question section compared to the undergraduate medical students (P<0.05). Similarly, the RTME students obtained higher scores on the process assessment of the doctor-patient communication course than undergraduate medical students, resulting from higher scores on the dimensions of information collection, information giving, negotiation and resolution, and nonverbal communication skills (P<0.05), and there was no statistically significant difference in the scores on the dimension of establishing first impression (P>0.05). Over 80% of RTME students felt satisfied or absolutely satisfied with the content, pedagogical measures, faculty, schedule and effects of the ladderlike communication skill course, and more than 60% believed it helped or absolutely helped promote learning interest, increase confidence to encounter difficult patients, and raise multiple competence, including empathy, doctor-patient communication, language expression, problem resolution, and team work.

The ladderlike communication skill course significantly elevates the effects of doctor-patient communication education in the phase of undergraduate medical education for the RTME students, facilitates the development of doctor-patient communication competence and other comprehensive competence. The ladderlike course mode is an effective measure fostering doctor-patient communication competence of medical students in medical education, and makes a useful reference for communication competence training for postgraduate education and continuing education of general practice.

Hierarchical diagnosis and treatment system is crucial for deepening the medical and health system reform and establishing the basic medical and health system with Chinese characteristics. Primary care institutions play an essential role in hierarchical diagnosis and treatment system by assuming the role of "gatekeepers" of residents health. The post competency of general practitioners, who are the core of primary care institutions, significantly influences the service capacity of these institutions.

To construct an indicator system for the evaluation of post competency of general practitioners in primary care institutions.

From September to December 2022, 13 medical professionals were consulted through two-round Delphi expert consultation method; the hierarchical analysis and entropy method was used to calculate the weights of the indicators.

The indicator system was optimized and sifted through two rounds of Delphi expert consultation, the evaluation system of primary general practitioners was finally constructed, consisting of 5 primary indicators and 27 secondary indicators. The weights of the indicators at all levels were clarified through the hierarchical analysis combined with the entropy method, in which the basic public health service capacity indicator had the highest weight and was the core indicator. The indicator system was tested for reliability and validity by small samples, and all of them were at an acceptable level.

An indicator system for evaluation the post competency of general practitioners in primary care institutions was constructed, contributing to the selection and appointment of general practitioners, which will provide an objective reference for the evaluation of post competence of general practitioners in primary care institutions.

Ensuring the quality of general practice faculty is not only an important basis for training qualified general practitioners, but also relates to the relationship between general practice and other professional disciplines, which is an important guarantee for improving the status of general practice and promoting the development of general practice. This article summarizes the roles and functions, admission standards, quality evaluation standards, and certification standards of general practice faculty by reviewing the websites and literature related to the training of general practitioners and general practice teachers at home and abroad, and prospects the quality evaluation and certification indicator system for general practice teachers in our country in the future, suggests that a quality evaluation and certification indicator system for general practice teachers should be constructed and adapted to national conditions in China, an authoritative professional committee for general practice teachers should be established, the standards for the admission, evaluation and assessment of general practice teachers should be formulated, and a systematic and complete management system for the training of general practice teachers should be established. This paper also suggests to select 1 or 2 excellent general practice faculty training bases in each province, to establish a relatively fixed and high-quality team of general practice faculty, which can provide a useful reference for the continuous quality improvement of general practice faculty training in China.

The education of general practice has developed rapidly in recent years in China, but there is still a lack of comprehensive survey for undergraduate general practice education.

To understand the current situation and development trend of undergraduate general practice teaching in China.

A questionnaire survey was conducted to investigate the offices of academic affairs of all colleges and universities offering clinical medicine programs in China (n=189) in December 2019, the questionnaires included teaching institutions, faculty and curriculum construction of general practice, which were collected in June 2020. The colleges and universities were categorized into four types for analysis, including comprehensive universities, single-subject colleges (medical colleges or pharmaceutical colleges) , Chinese medicine (TCM) colleges and independent colleges to compare differences in the teaching of undergraduate general practice at different types of colleges and universities.

A total of 175 valid questionnaires were returned, with a response rate of 92.6%. In 2019, 85.7% (150/175) of colleges and universities had undergraduate general practice teaching institutions, and the total number of general practice faculty members in colleges and universities nationwide reached 3 371, with 59.8% (2 016/3 371) of them working in the department of general practice in affiliated hospitals. Among the 175 colleges and universities that participated in the survey, 142 (81.1%) offered elective or compulsory courses in general practice, 68 (38.9%) offered graduation practice in general practice in community health centers, and 22 (12.6%) offered graduation practice in general practice in general hospitals. Among the four types of colleges and universities, the proportion of general practice departments set up in general hospitals and affiliated hospitals of single-subject colleges was over 90.0%, the proportion of TCM colleges was 70.0% (7/10) , and the proportion of independent colleges was only 63.3% (19/30) ; the proportion of independent colleges offering elective or compulsory courses in general practice was 60.0% (18/30) , while the proportions of other three types of colleges and universities offering elective or compulsory courses were ≥80.0%. The proportion of single-subject colleges carrying out graduation practice in general practice in community health centers was the highest (61.2%, 30/49) , followed by comprehensive universities (36.0%, 31/86) , and the proportions of independent colleges and TCM colleges were≤20.0%; the proportion of comprehensive universities and single-subject colleges carrying out graduation practice in general practice in general hospital was over 10.0%, while the proportion of independent colleges was 6.7% (2/30) .

The development of undergraduate general practice education has been relatively rapid in recent years, but there are still many problems, such as general practice undergraduate education is not widely carried out and developed unevenly, non-community faculty members lack practice experience in primary care, teaching and evaluation methods are simple. There is still a need to further improve the universality and balance of development in the future, and to strengthen teacher training, and enrich teaching methods and evaluation tools.

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.

The training ability of community preceptors is an important factor related to the quality of standardized training for general practitioners (GPs) . In recent years, training programs for community GP preceptors have been conducted in several regions of China, but no research evaluated the implementation of these programs using a comprehensive approach so far.

To explore the current situation and obstacles to the implementation of training program of Graded-Supervised Ambulatory Training by the Second Affiliated Hospital of Zhejiang University School of Medicine, and provide theoretical references and strategic support for the development of problem-oriented countermeasures.

From October 2021 to January 2022, the implementation status of Graded-Supervised Ambulatory Training program by the Second Affiliated Hospital of Zhejiang University School of Medicine was systematically evaluated based on CIPP model from four aspects of context, input, process and product, using multiple research methods such as content analysis, expert panels, in-depth interviews, expert rating, and surveys.

The results of policy document analysis and literature review indicated that community preceptor's training is strongly supported by national health policies, and has been widely implemented in China. The training system developed by the Second Affiliated Hospital of Zhejiang University School of Medicine basically covers the content and process of community preceptor training programme, while the assessment and incentive system developed by the community lacks of detailed instructions. From May 2021 to January 2022, ten community preceptors completed 57 times of ambulatory training, each attending four to seven times. The average score of ability of ambulatory training increased from (78.6±5.7) in the first round to (87.8±4.5) in the seventh round. The satisfaction rates of "site and equipment of training" "training forms" "content of training" and "effect of training" were over 90% among community preceptors and GP residents, yet the satisfaction rate of "proper incentives" among community preceptors was only 20%. Participants reported that the main barriers at present were "imperfect incentive system" "difficulties in recruiting appropriate patients" and "inapplicable training content" .

In the initial stage, the Graded-Supervised Ambulatory Training programme has achieved desired results in many aspects, but there is still room for improvement. In the next stage of training, countermeasures should be formulated based on the actual situation of the community practice base to continuously improve the quality of training.

Training general practitioners (GPs) and improving the practice competence of "GP-centered" primary health care personnel are important directions of the development of human resources for primary health care in China. At present, there is lack of an index system applicable to evaluate clinical competence of GPs in the circumstances of primary health care in China, which not only hampers accurate identification of gaps in clinical competence of GPs, but also impedes sustainable improvement of the education and training of GPs as well as primary health care personnel.

To develop an evaluation index system for consultation competency of GPs in the circumstances of primary health care in China based on the original version of Leicester Assessment Package (LAP), so as to provide an index model reference for the objective evaluation of consultation competency of GPs.

Between May to August in 2022, a total of 15 experts were invited by using the purposive sampling method to implement the Delphi method by correspondence, to evaluate the importance, feasibility, and textual representation of each index in the initial evaluation index system for consultation competency of GPs. Analytic hierarchy process was adopted to calculate weight and combined weight for the first-level and secondary-level indexes.

A total of two rounds of Delphi were conducted. The positivity coefficient, familiarity level, judgment coefficient, and authority coefficient were 100%, 0.77, 0.91, and 0.84 in both rounds of consultation; the mean score of the importance and feasibility of each indicator was 3.5, and the variation coefficient was 0.3. The Kendall coefficients for the importance and feasibility of the indexes in the two rounds of consultation were statistically different (P<0.001) and higher in the second round than in the first round. A total of 10 comments recommended to increase indexes, one comment to combine indexes, and 29 comments to modify indexes were collected during two rounds of Delphi consultation. The final version of evaluation system consisted of 7 first-level indexes and 42 second-level indexes, the weights of the 7 primary indicators ranged from 13.61% to 14.69%, and the combined weights of the secondary indicators ranged from 0.95% to 4.91%.

This study has constructed an evaluation index system for consultation competency of GPs in the circumstances of primary health care in China based on the original version of LAP. The evaluation index system includes 7 first-level indexes and 42 second-level indexes, which covers each essential section and important missions in GP consultations with high scientificity and practicality.

Currently, there is a lack of clinical competence evaluation tools applicable of general practitioners (GPs) practicing in rural settings in China, resulting in the lack of researches on the clinical competence evaluation of GPs in rural.

To explore reliability and validity of an evaluation index system for consultation competency of rural GPs developed previously, and provide an evaluation tool with high reliability and validity for scientific and objective assessment of consultation competence of GPs in rural settings.

Based on the evaluation system for consultation competency of rural GPs, a corresponding questionnaire was designed, and points were assigned to each option on a 5-point Likert scale. From September to December 2022, GPs or assistant general practitioners (AGPs) who were working in rural township health centers in Guangxi Province were recruited as the research subjects by using the purposive sampling and stratified sampling methods, the questionnaire was distributed through a national web-based survey platform-"WJX" to them. Cronbach's α coefficient, split-half coefficient, critical ratio (CR) and correlation coefficients were calculated based on questionnaire data. Confirmative factor analysis was employed to fit questionnaire data and assumed model, and calculate three categories of indicators, including preliminary fit criteria (PFC), overall model fit (OMF), and fit of internal structural model (FISM), to verify the degree of fit and structural validity of the measured data.

A total of 600 questionnaires were distributed and 366 were validly collected, with an effective recovery rate of 61.0%, 86.1% were registered as GPs and 13.9% as AGPs, who came from five cities, including Nanning, Guilin, Wuzhou, Baise, and Guigang, and 204 township health centers in Guangxi Province. Cronbach'α coefficient for the whole questionnaire or for every section was higher than 0.700, and Guttman Split-Half coefficient was 0.931. The initial first-order model met the PFC well; except for goodness of fit index (GFI), adjusted goodness of fit index (AGFI), and normed fit index (NFI), other indicators related to the OMF reached for the best levels in the modified first-order model. Apart from R² for 9 observable variables less than 0.5, the FISM for the modified first-order model showed good effects. The initial second-order model indicated as similar effects on the PFC as the initial first-order model; the modified second-order model shared similar OMF with the modified first-order model; the modified second-order model was inferior to the modified first-order model in terms of the FISM. Eventually, questionnaire data fitted the modified first-order model better.

The evaluation index system for consultation competency of rural GPs shows high reliability and validity, which can be used for research and practical work on the evaluation of consultation competence evaluation of GPs in rural settings.

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.

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.

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.

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 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.

The long-term and stable development of the general practitioner workforce is crucial to the implementation of policies related to contracted family doctor services, the continuous promotion of construction of the hierarchical diagnosis and treatment system, and the realization of national strategic goals for achieving "big health". Whether a general practitioner continues to work in general practice depends primarily on his confidence in the profession. Exploring the perceptions toward general practice as a career among general medical graduates finishing the standardized general residency training program (SGRTP) , can provide a reference for the improvement of training content and relevant policy formulation. However, there are few relevant studies.

To explore the perceptions toward general practice career among non-targeted admission general medical graduates completing the SGRTP, offering insights into how to better retain general practice talents.

In August 2021, stratified cluster random sampling was used to select non-targeted admission general medical graduates who had been admitted to the SGRTP in 10 standardized general residency training bases in Henan Province during 2014 to 2017, and completed the SGRTP as of the survey date. They attended a self-administered survey conducted through an online platform named "Wenjuanxing", using a questionnaire developed by our research group for understanding their general information, standardized training information, current work situation and perceptions toward a career in general practice.

Three hundred and twenty-six cases attended the survey, and 271 (83.1%) of them who handed in responsive questionnaires were finally included, among whom 77 (28.4%) went into the career of general practice after the completion of SGRTP. Compared with their counterparts who did not work in general practice following the completion of training, the trainees who worked in general practice rated the disciplinary position of general medicine and the social position of general practitioners higher (P<0.05) . Moreover, the percentage of them〔80.5% (62/77) 〕 intending to work in general practice in their whole life was higher (P<0.05) . The score for disciplinary position of general medicine rated by the trainees varied by age and whether or not being the only child of the family (P<0.05) . The score for social position of general practitioners rated by the trainees varied by maternal education level (P<0.05) . The score for the career prospect of general practitioners rated by the trainees varied by age (P<0.05) . Age, marital status, education level, maternal occupation, and current work unit were associated with the differences in scores for intending to be a general practitioner in the whole life given by the trainees (P<0.05) . The top three factors limiting the development of general medicine according to the trainees were "inadequate supporting policies" (150 cases, 55.4%) , "low salary for general practitioners" (146 cases, 53.9%) , and "poor equipment in primary care" (137 cases, 50.6%) . The rates of trainees choosing restrictors of the development of general medicine did not vary by whether or not working in general practice following the completion of SGRTP (P>0.05) . The top three advantages of primary care institutions were "better health guidance for residents" (213 cases, 78.6%) , "optimal allocation of medical resources, relieving pressure on major hospitals and avoiding waste of resources" (165 cases, 60.9%) , and "solving the problem of'seeing a doctor is difficult and expensive' among the masses" (162 cases, 59.8%) . The rates of trainees choosing the options of advantages of primary care institutions did not vary by whether or not working in general practice following the completion of SGRTP (P>0.05) . The top three disadvantages of primary care institutions according to the trainees were "low salary for general practitioners" (212 cases, 78.2%) , "poor hardware and equipment" (181 cases, 66.8%) , and "inadequate social security mechanism" (111 cases, 41.0%) . The rate of trainees choosing "inadequate social security mechanism" or "great concern in educational issues for children due to backward development in remote rural areas" varied by whether or not working in general practice following the completion of SGRTP (P<0.05) , but the rate of choosing each of the other options of disadvantages of primary care institutions did not (P>0.05) .

Age, education level, marital status, mother's education level and occupation, whether or not being the only child in the family, and current work unit were associated with the perceptions toward general practice career in non-targeted admission general medical graduates completing the SGRTP. The supporting policies and salary system are main factors affecting the development of general medicine and primary care institutions, and priority should be given to the allocation of hardware and equipment and the education guarantee for children of general practitioners.

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.

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.

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.

Continuing medication education for in-service general practitioners (GPs) is a key measure for strengthening the primary health care system, and the department of general medicine in a tertiary general hospital is an important institution undertaking the trainings for GPs. We introduced the development of a staged continuing medical education model for GPs initiated since 2020 by Deqing County Government with Health Bureau of Deqing County in collaboration with Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine and medical educations in Deqing, with a detailed description of the three stages of development, namely the formation of medical and educational framework of Sir Run Run Shaw Hospital in cooperation with the Deqing County Government and medical institutions in Deqing, the construction of "Sir Run Run Shaw Hospital-Deqing" regional GPs education community, and the implementation of trainings for GPs in primary care by the education community using a strategy of "hierarchical and progressive teaching, and cyclic strengthening". The development of this model will offer a reference for the construction of a regional GP training model using the cooperative framework between county-level government and medical institutions and the department of general practice in a tertiary general hospital.

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.

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.

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.

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.

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.

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.

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.

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.