农村订单定向免费医学生的培养及其对基层公共卫生服务的影响研究

目的 探讨农村订单定向免费医学生的培养及其在基层公共卫生服务中的影响，为进一步提升农村定向全科医生培养方案的有效性提出针对性建议。方法 通过访谈四川省基层医疗机构的63名毕业后的农村订单定向免费医学本科学生，研究采用了主轴编码和内容分析的标准程序，深入分析了农村订单定向免费医学生培养效果对基层公共卫生服务作用的影响及不足。结果 研究发现，农村订单定向免费医学生培养成效主要体现在理论学习、实践工作能力、未来职业规划与毕业后教育情况几个方面，其中理论学习与实践工作能力2个维度的培养成效较好。农村订单定向免费医学生在基层公共卫生服务中发挥了积极作用，主要体现在重点人群的防护、老年人群及慢性病患者居家预防和管理、儿童和孕产妇人群居家预防和管理。结论 针对农村订单定向免费医学生对基层公共卫生服务的建议措施包括：国家和学校的配套政策能继续完善和执行、高校教师应更加注重全科医学生的人文精神的引导、课程体系建设中需突出基层及全科医学相关的课程、学生培养过程中应构建有效的实践方式、加强就业后的继续教育等方面。

On the training of rural-order tuition-waived medical students and its impact on grass-roots public health services

Objective To discuss the role of rural-order tuition-waived medical students in grass-roots public health, and put forward pertinent suggestions for further improving the effectiveness of rural directional general practitioner training programs.Methods Through interviews with 63 graduated rural-order tuition-waived medical undergraduates from rural primary medical institutions in Sichuan Province, the standard procedures of spindle encoding and content analysis were used to analyze the influence of the training effect of rural-order tuition-waived medical students on grass-roots public health services.Results The results showed that the training effect of rural-order tuition-waived medical students mainly reflected in theoretical learning, practical work ability, future career planning and post-graduation education, among which the training effect of theoretical learning and practical work ability was better. Rural-order tuition-waived medical students played a positive role in grass-roots public health services, mainly in the protection of key populations, home prevention and management of the elderly and chronic diseases patients, and home prevention and management of children and pregnant women.Conclusion The measures for rural-order tuition-waived medical students to provide grass-roots public health services should include that the supporting policies of the state and schools can be continuously improved and implemented, college teachers should pay more attention to the guidance of the humanistic spirit of general medical students, and the curriculum system construction of rural-order tuition-waived medical students should highlight the courses related to grass-roots and general medicine. In the process of student training, we should construct effective practical methods and strengthen post-employment continuing education.