北京市西城区月坛社区卫生服务中心医务人员继续医学教育情况分析

背景　继续医学教育（CME）可以不断提高医务人员的专业知识和技能水平，但存在组织形式单一、满意度低等问题，通过统计分析北京市西城区首都医科大学附属复兴医院月坛社区卫生服务中心（月坛社区）医务人员CME现状、发现CME实施过程中存在的主要问题，可有效提高CME效果。目的　统计分析月坛社区医务人员的CME情况，探讨影响医务人员参加CME的主要原因，为促进开展在线CME项目、解决工学矛盾、提高效率和质量提供理论依据。方法　对2015年11月-2018年10月月坛社区561例参加CME医务人员的情况进行分析，主要包括以下内容：必修课程（包括市级必修课、区级必修课和全员必修课）、课程项目（区级慢性病课程、区级传染病课程和单位自管课程）、培训/会议（包括培训、会议或交流，分别统计主动参加类和被动参加类）、主办或承办项目（国家级、市级、区级CME项目）。由2名研究员独立统计，并将统计结果合并，如存在不一致，则重新核对。采用非结构访谈法对参加过CME的10例医务人员进行访谈，内容为影响医务人员参加CME的主要原因。结果　必修课包括市级必修课、区级必修课和全员必修课，3年共计561人次参加课程，其中市级必修课总时长为8 376学时（面授课程221学时，在线课程8 155学时），区级必修课3 366学时（均为面授课程），全员必修课3 366学时（均为在线课程）。课程项目包括区级慢性病课程、区级传染病课程和单位自管课程，全部以面授课的形式开展。共开展课程79次，平均2.2次/月，其中慢性病课程57次（72.2%），传染病课程22次（27.8%）。共计4 068人次医务人员参加课程，平均52人次/次，慢性病课程34人次/次，传染病课程96人次/人。每年第三季度（5月、6月和7月）为CME黄金期，开展CME项目较多，且签到率较其他季度高。培训/会议分为被动参加类、主动参加类，均为面授项目。参加培训/会议共计104项，平均4.3项/月，共计244人次参加。2017年度被动参加类29次（85人次）、主动参加类17次（26人次），2018年度被动参加类38次（92人次）、主动参加类20次（67人次）。主办（承办）项目21项，均以面授形式开展.接受小组访谈的 10 例医务人员均认为工学矛盾为影响其参加CME的主要原因。结论　月坛社区CME项目丰富，以传统面授课程为主，医务人员参加CME项目积极性高，工学矛盾为医务人员面临的主要问题，建议适当开展在线CME项目以提高效率和质量。

Status of Continuing Medical Education in Medical Professionals in Yuetan Community Health Center，Xicheng District，Beijing

Background　Continuing medical education（CME） can continually improve the professional knowledge and skills of medial professionals. But current forms of CME are undiversified，and the contents are very unsatisfactory. To improve the effectiveness of CME，we evaluated the status and main problems of CME received by medial professionals from Yuetan Community Health Center，Fuxing Hospital，Capital Medical University，Xicheng District，Beijing（Yuetan Community Health）. Objective　To perform a statistical analysis of CME status in medical professionals from Yuetan Community Health，and to identify the main factors associated with attending the participation in CME，providing a theoretical basis for promoting the development of online CME programs，resolving the work–study conflict，and improving the efficiency and quality of CME. Methods　CME received by 561 medical professionals from Yuetan Community Health Center，Fuxing Hospital，Capital Medical University，Xicheng District，Beijing，during November 2015 to October 2018 was analyzed，which mainly includes the following：compulsory courses（municipal-，district- and staff-level compulsory courses），specialty courses（district-level chronic disease courses，district-level infectious disease courses，specialty courses educated by the healthcare institution itself），trainings/conferences（actively and passively participated trainings，conferences or exchanges），and sponsored or hosted projects（national-，municipal- and district-level projects）. The analysis results were counted by two researchers separately，and if their statistical results were not inconsistent，the data were reviewed till consistency was obtained. Unstructured interviews with 10 medical professionals were conducted to explore their perspectives of major factors associated with participating in CME. Results　A total of 561 cases received the continuing education of compulsory courses during three years，including 8 376-hour（221-hour face-to-face courses and 8 155-hour online courses） municipal-level compulsory courses， 3 366-hour district-level courses（all face-to-face courses），and 3 366-hour staff-level courses（all online courses）. Specialty courses were all taught in a face-to-face way.Continuing education of such courses were conducted for a total of 79 times，with an average of 2.2 times per month.In particular，chronic disease courses were taught for 57 times（72.2%），and infectious disease courses were taught for 22 times（27.8%）. The total number of cases learning such courses was 4 068（averaged 52 cases in each training）. Specifically，the average number of cases learning chronic disease courses，and infectious disease courses in each training was 34，and 96，respectively. There were more CME projects and a higher attending rate in the third quarter（May，June，and July） of each year. All actively and passively participated trainings/meetings were conducted in a face-to-face way. The total number of trainings/conferences conducted was 104，with an average number of 4.3 per month. And the number of participated cases was 244. In 2017，85 cases passively participated in 29 trainings/conferences，and 26 cases actively participated in 17 trainings/conferences. In 2018，92 cases passively participated in 38 trainings/ conferences，and 67 cases actively participated in 20 trainings/conferences. The total number of sponsored or hosted projects was 21，and all were conducted in a face-to-face way. All the interviewees considered that conflict between work and study was the major factor associated with participating in CME. Conclusion　The CME programs received by medical professionals from Yuetan Community Health are various，and are mainly conducted in the traditional face-to-face way. The medical professionals show high initiative in attending CME，and the most important problem faced by them is work-study conflict. In view of this，online CME programs are suggested to be carried out appropriately to improve the efficiency and quality of CME.