重庆市社区医生在职培训的需求分析及对策研究

目的了解重庆市社区医生的在职培训需求,制订与其相适应的培训计划。方法分层抽取12个社区卫生服务机构,调查12名社区医师的日常工作内容和61名新上岗社区医师的岗位适应能力;访谈机构负责人和社区医生,收集其对在职人员的培训建议。结果社区医师工作内容中排列前五位的依次为:常见症状诊治、常见疾病诊治、慢病管理、健康档案、留观患者;新上岗社区医生中有54.1%转诊过患者(其中1/3是因缺乏诊疗技术),有75.4%感到医患关系紧张,有77.0%经常使用诊疗设备,但是能正确使用检眼镜、检耳镜、康复评定与治疗设备的人员仅占8.2%。结论社区医生在职培训应采取"以社区为基础的教育结合问题为基础的学习"的培训模式,针对性地开展常用诊疗技术(含设备使用)、基本公共卫生服务和人际沟通等方面知识与技能的培训。

Job-training Demands and Plans for Community Doctors in Chongqing

Objective To explore the job-training demands of community doctors in Chongqing and establish a suitable training program.Methods Twelve community health service organizations were chosen by stratified sampling.The routine work of 12 community doctors and post adaptability of 61 new community doctors were recorded and assessed.Organization heads and community doctors were interviewed and their suggestions about job-training were collected.Results The 5 major work contents of community doctors were diagnosis and treatment of symptoms and diseases,chronic disease management,managing health records and observing patients.54.1% of new community doctors had had patients referred to another medical institute(1/3 for lacking treating techniques),75.4% felt tense doctor-patient relations,77.0% often used diagnostic and treatment equipments,but only 8.2% could correctly use ophthalmoscope,otoscope and equipments for rehabilitation assessment and treatment.Conclusion "Community-based education combined with problem-oriented learning" training model should be adopted for the job-training of community doctors.Common treating techniques(including equipment use),basic public health services and interpersonal communication skills should be top on the list of community doctors′ job-training curriculum.