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我国全科医生继续医学教育政策执行的制约因素及优化路径研究

吴爽 席彪

吴爽, 席彪. 我国全科医生继续医学教育政策执行的制约因素及优化路径研究[J]. 中华全科医学, 2023, 21(12): 1995-1999. doi: 10.16766/j.cnki.issn.1674-4152.003275
引用本文: 吴爽, 席彪. 我国全科医生继续医学教育政策执行的制约因素及优化路径研究[J]. 中华全科医学, 2023, 21(12): 1995-1999. doi: 10.16766/j.cnki.issn.1674-4152.003275
WU Shuang, XI Biao. The restrictive factors and optimization of continuing medical education policy for general practitioners in China[J]. Chinese Journal of General Practice, 2023, 21(12): 1995-1999. doi: 10.16766/j.cnki.issn.1674-4152.003275
Citation: WU Shuang, XI Biao. The restrictive factors and optimization of continuing medical education policy for general practitioners in China[J]. Chinese Journal of General Practice, 2023, 21(12): 1995-1999. doi: 10.16766/j.cnki.issn.1674-4152.003275

我国全科医生继续医学教育政策执行的制约因素及优化路径研究

doi: 10.16766/j.cnki.issn.1674-4152.003275
基金项目: 

河北省高等学校人文社会科学研究项目 SD201013

河北省高等学校人文社会科学重点研究基地“华北理工大学卫生健康政策与管理研究中心”项目 WG202303

详细信息
    通讯作者:

    席彪,E-mail: 13931984969@163.com

  • 中图分类号: R192.3  R499

The restrictive factors and optimization of continuing medical education policy for general practitioners in China

  • 摘要: 继续医学教育是医学教育体系的重要组成部分,全科医生继续医学教育对提升全科医生岗位胜任力、提高基层医疗服务水平发挥着日益重要的作用。当前我国全科医生继续教育处于探索完善阶段,全科医生继续医学教育仍面临诸多问题,其中执行难和执行效果存在偏差是深入推进全科医生继续医学教育的制约因素。本研究在了解全科医生继续医学教育政策发展历程和推行现状的基础上,以史密斯模型的理论框架为指导,从政策本身、政策执行机构、政策目标群体及政策执行环境多角度对全科医生继续医学教育政策执行困境予以分析。研究发现,我国全科医生继续医学教育政策系统性不足、政策方案与需求脱节;执行机构间协同管理不畅,执行过程监督考核缺乏,全科师资的数量质量不足;全科医生的培训需求存在差异,参与积极性不足以及各地区经济差异、居民认可度低和全科医生职业认同感不高的经济、社会政策环境等方面均为阻滞政策执行的重要因素。基于此,建议从完善政策框架设计、明确执行机构职责和加强执行能力、提升目标群体参与认同感与积极性、优化全科继续医学教育政策的执行环境等主要方面着手突破继续医学教育政策执行的制约因素,探索我国全科医生继续医学教育可持续发展的优化路径。

     

  • 图  1  史密斯模型

    Figure  1.  Smith policy implementation model

    图  2  全科医生继续医学教育政策执行的优化路径

    Figure  2.  Pathway optimization for implementing the continuing medical education policy for general practitioners

  • [1] 郭远美, 贾雪梅, 朱俊勇, 等. 我国全科医师继续教育的现状及对策[J]. 中华医学教育杂志, 2020, 40(9): 717-720. doi: 10.3760/cma.j.cn115259-20191023-00882

    GUO Y M, JIA X M, ZHU J Y, et al. Situation and countermeasures of continuing medical education for general practitioners in China[J]. Chinese Journal of Medical Education, 2020, 40(9): 717-720. doi: 10.3760/cma.j.cn115259-20191023-00882
    [2] 施丹丹, 雍刚, 马骏, 等. 上海市长宁区全科医生继续医学教育需求的质性研究[J]. 中华全科医师杂志, 2020, 19(6): 517-521. doi: 10.3760/cma.j.cn114798-20190924-00726

    SHI D D, YONG G, MA J, et al. Survey on the needs of continuing medical education for general practitioners in Changning District, Shanghai[J]. Chinese Journal of General Practitioners, 2020, 19(6): 517-521. doi: 10.3760/cma.j.cn114798-20190924-00726
    [3] 刘瑞明, 陈琴, 肖俊辉, 等. 我国家庭医生签约服务政策执行的制约因素与优化路径: 基于史密斯政策执行过程模型[J]. 中国全科医学, 2022, 25(7): 782-790. doi: 10.12114/j.issn.1007-9572.2021.00.324

    LIU R M, CHEN Q, XIAO J H, et al. Barriers and Improving Paths to the Implementation of Contracted Family Doctor Services in China: an Analysis Using Smith ' s Policy Implementation Process Model[J]. Chinese General Practice, 2022, 25(7): 782-790. doi: 10.12114/j.issn.1007-9572.2021.00.324
    [4] 杨慧敏, 尹德卢, 辛倩倩, 等. 我国基层全科医生继续医学教育现状调查[J]. 中华全科医学, 2018, 16(8): 1375-1378. doi: 10.16766/j.cnki.issn.1674-4152.000376

    YANG H M, YIN D L, XIN Q Q, et al. Current status of continuing medical education for primary general practitioners in China[J]. Chinese Journal of General Practice, 2018, 16(8): 1375-1378. doi: 10.16766/j.cnki.issn.1674-4152.000376
    [5] 黄劲松. 针对新医改环境下全科医生继续教育问题的思考与建议[J]. 现代医院管理, 2022, 20(1): 59-62.

    HUANG J S. Thoughts and Suggestions on Continuing Education of General Practitioners under the New Medical Reform Environment[J]. Modern Hospital Management, 2022, 20(1): 59-62.
    [6] 吴瑶瑶, 吴素雄, 陈勇. 全科医生培养政策的执行困境与路径完善: 基于霍恩-米特模型[J]. 卫生经济研究, 2022, 39(5): 78-81.

    WU Y Y, WU S Y, CHEN Y. Implementation Dilemma and Path Improvement of General Practitioner Training Policy: Based on Horn-Meter Model[J]. Health Economics Research, 2022, 39(5): 78-81.
    [7] 陈思铧, 钱卫国, 席彪. 新形势下我国继续医学教育的挑战、镜鉴与对策[J]. 医学与社会, 2021, 34(12): 105-111.

    CHEN S H, QIAN W G, XI B. Challenges, References and Countermeasures of CME in China Under the New Situation[J]. Medicine and Society, 2021, 34(12): 105-111.
    [8] 尤丛蕾, 姚弥, 齐建光. 全科医学师资对全科医学继续教育现状看法的定性研究[J]. 中国全科医学, 2021, 24(34): 4364-4371. doi: 10.12114/j.issn.1007-9572.2021.00.302

    YOU C L, YAO M, QI J G. General Practitioner Trainers ' Perspectives on Continuing Medical Education in General Practice in China: a Qualitative Study[J]. Chinese General Practice, 2021, 24(34): 4364-4371. doi: 10.12114/j.issn.1007-9572.2021.00.302
    [9] 陈海燕. 基层医院全科医师继续医学教育模式探索[J]. 教育教学论坛, 2020(52): 184-185.

    CHEN H Y. Exploration on the Model of Continuing Medical Education for General Practitioners in Primary Hospitals[J]. Education Teaching Forum, 2020(52): 184-185.
    [10] 李艳超, 张淑娥, 张进, 等. 全科医生组织支持感与工作压力的关系: 职业认同感的中介作用[J]. 中华医学教育探索杂志, 2020, 19(5): 609-614.

    LI Y C, ZHANG S E, ZHANG J, et al. Relationship between perceived organizational support and occupational pressure of general practitioners: the mediating role of professional identity[J]. Chinese Journal of Medical Education Research, 2020, 19(5): 609-614.
    [11] 杜郁华, 戴维, 倪衡如. 宝山区全科医生继续医学教育现状调查[J]. 中国社区医师, 2020, 36(19): 179-180, 182.

    DU Y H, DAI W, NI H R. Investigation on the current situation of continuing medical education for general practitioners in Baoshan District[J]. Chinese Community Doctors, 2020, 36(19): 179-180, 182.
    [12] 马志强, 林枫, 欧阳晨慧, 等. 基层医疗卫生服务机构全科医生技能培训现状与对策[J]. 卫生软科学, 2020, 34(10): 99-104.

    MA Z Q, LIN F, OUYANG C H, et al. Status and countermeasures of general practitioners skills training in primary medical health service institutions[J]. Soft Science of Health, 2020, 34(10): 99-104.
    [13] 孔华俊, 应争先, 汪莉, 等. 县域医共体下社区医院全科医生模块化培训的实践研究[J]. 中华医学教育探索杂志, 2023, 22(2): 276-279.

    KONG H J, YING Z X, WANG L, et al. Practical study on modular training of general practitioner in community hospitals under county medical community[J]. Chinese Journal of Medical Education Research, 2023, 22(2): 276-279.
    [14] 汪亚男, 陈红, 赵光斌, 等. 四川省全科医生继续教育培训现状与需求调查[J]. 中华全科医学, 2023, 21(6): 1039-1043. doi: 10.16766/j.cnki.issn.1674-4152.003044

    WANG Y N, CHEN H, ZHAO G B, et al. Investigation on the current situation and need of continuing education training for general practitioners in Sichuan Province[J]. Chinese Journal of General Practice, 2023, 21(6): 1039-1043. doi: 10.16766/j.cnki.issn.1674-4152.003044
    [15] 孟佳, 郭萌, 王君颖, 等. 基于扎根理论探讨全科医生专长化培训方案的优化[J]. 中华全科医学, 2023, 21(7): 1224-1228. doi: 10.16766/j.cnki.issn.1674-4152.003089

    MENG J, GUO M, WANG J Y, et al. Exploration the optimization of the special interests training program for general practitioners based on grounded theory[J]. Chinese Journal of General Practice, 2023, 21(7): 1224-1228. doi: 10.16766/j.cnki.issn.1674-4152.003089
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出版历程
  • 收稿日期:  2023-08-07
  • 网络出版日期:  2024-01-29

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