我国基层全科医生继续医学教育现状调查

目的 调查基层全科医生继续医学教育师资、形式和内容现状以及存在的问题,为进一步改善全科医生继续医学教育政策,提高现有基层全科医生服务能力提供依据。 方法 采用整群随机抽样和方便抽样相结合的方法,于2017年5月在我国东中西部13个省共抽取54家基层医疗卫生机构作为样本单位,采用自行设计的问卷对其全科医生共670人进行问卷调查,采用Epidata 3.1录入数据并核对,使用SAS 9.1统计学软件进行统计分析,P<0.05为差异有统计学意义。 结果 师资:主要来自三级医院及专科医院,占49.85%;来自基层医疗卫生机构的师资较少,只有9.88%;与其他地区相比,东部地区来自基层医疗卫生机构的师资最多,占11.98%。形式:以学术讲座、培训班和网络学习等形式为主;操作实践和实地参观等开展较少,只占8.96%;网络学习形式在西部和农村地区开展更多。内容:主要集中在合理用药和疾病诊疗等方面,80%以上的全科医生都有参加。另外发现,目前基层全科医生对继续医学教育师资、形式和内容的满意度均处于较低的水平,分别是59.28%、49.32%和53.07%;并且不同地区、学历和职称的全科医生满意度有所不同,高级职称全科医生满意度最低。 结论 基层全科医生对继续医学教育的整体满意度较低。基层全科医生继续医学教育应兼顾不同地区和不同层次全科医生的需求,开展不同的培训内容;丰富形式,增加继续医学教育吸引力;另外还要加强基层医疗卫生机构师资的培养。 

Current status of continuing medical education for primary general practitioners in China

Objective To investigate current status including teachers, forms and contents of continuing medical education for primary general practitioners in China, and provide scientific evidences for continuing medical education policy. Methods Cluster random sampling and convenient sampling method was used in this study. In May 2017, a questionnaire survey was carried out among 670 general practitioners from 54 Primary health institutions of 13 Provinces in China. Epidata 3.1 was used to enter data and all analyses were conducted with SAS 9.1 statistical package. P<0.05 was considered statistically significant. Results Continuing medical education teachers were mainly from tertiary hospitals or specialized hospitals, accounting for 49.8%, and only 9.88% of the teachers came from the primary health institutions. Compared with other regions, the eastern region had more teachers who came from primary health institutions, accounting for 11.98%. Continuing medical education for primary general practitioners was mainly carried out in the form of academic lectures, training class and online education; and operation practice and field visit was less, only 8.96%. Online education was conducted more in western region and rural area. In addition, the content of continuing medical education concentrated in the rational use of drugs and disease diagnosis and treatment, etc. It was also found that the rate of teacher satisfaction was 59.28%, teaching form was 49.32%, and content was 53.07%. Moreover, the satisfaction of general practitioners differs in different regions, educational backgrounds and professional titles. Conclusion The overall continuing medical education satisfaction was at a low level. The results indicated that to improve the quality of continuing medical education for general practitioners in primary health institutions it is necessary to strengthen the teacher cultivation, enrich the forms and broaden the contents to meet the different needs of primary general practitioners.