四川省全科医生继续教育培训现状与需求调查

汪亚男; 陈红; 赵光斌; 林敏; 王钧慷; 王佳; 李杨

doi:10.16766/j.cnki.issn.1674-4152.003044

四川省全科医生继续教育培训现状与需求调查

doi: 10.16766/j.cnki.issn.1674-4152.003044

汪亚男¹,
陈红^1, ,,
赵光斌¹,
林敏²,
王钧慷²,
王佳¹,
李杨¹

1.
四川省人民医院全科医学中心，四川成都 610000
2.
四川省人民医院门诊部

基金项目:

四川省科技厅重点研发项目 2022YFS0264

详细信息

通讯作者:
陈红，E-mail: 3378069719@qq.com

中图分类号: R192.3 R499
计量
- 文章访问数: 170
- HTML全文浏览量: 44
- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2022-06-24
- 网络出版日期: 2023-08-26

Investigation on the current situation and need of continuing education training for general practitioners in Sichuan Province

1.
General Medical Center of Sichuan Provincial People ' s Hospital, Chengdu, Sichuan 610000, China

摘要

摘要: 目的分析四川省全科医生接受继续教育的现状及需求，为更有效地组织开展全科医生继续教育培训提供参考及依据。方法对2021年参加“四川省全科医生诊疗能力提升在线培训”的全科医生进行问卷星在线问卷调查，采用自制问卷《全科医生继续教育培训现状与需求调查表》，调查内容包括基本信息、既往培训情况及临床技能、辅助检查、系统知识、科研、培训方式等方面的培训需求，分析不同学历、职称及工作地点的全科医生对继续教育培训的需求有无差异。共计发放问卷1 804份，回收有效问卷1 463份，有效回收率为81.10%。结果 1 407人(96.17%)既往参加过继续教育培训，选择接受网络授课(1 008人，68.70%)和网络与现场结合(889人，60.76%)的授课方式最多，全科医生对临床技能、辅助检查、系统知识、科研方面的培训需求较大，不同学历、职称及工作地点的全科医生对临床技能、辅助检查、系统知识及科研的培训需求有差异，差异有统计学意义(P < 0.05)。结论目前全科医生对继续教育培训需求迫切，意愿强烈，不同背景的全科医生对继续教育培训内容需求存在差异，建议调整培训内容，建立靶向思维，实施精准培训，满足不同学历、职称、工作地点全科医生的需求，从而提高培训的效率，建议加强培训模式的创新，增加线上培训的开展。
- 四川省 /
- 全科医生 /
- 继续教育 /
- 需求
Abstract: Objective To analyze the current situation and need of continuing education for general practitioners in Sichuan Province, and provide reference and basis for organizing and carrying out continuing education training for general practitioners more effectively. Methods The general practitioners who joined the "online training for improving the diagnosis and treatment ability of General Practitioners in Sichuan Province" in 2021 were surveyed online. The self-made questionnaire "General Practitioners Continuing Education training Status and Demand" was used. The survey included basic information, previous training, clinical skills, auxiliary examination, systematic knowledge, scientific research, training methods needs. Whether there were differences in the need for continuing education training among general practitioners with different educational backgrounds, professional titles, and work locations were analyzed. A total of 1 804 questionnaires were sent out, 1 463 were effectively received with effective recovery of 81.10%. Results Total 1 407 people (96.17%) had joined the continuing education training, most of them chose network teaching (1 008, 68.70%) and combination of network and alive (889, 60.76%). General practitioners had a great demand for training in clinical skills, auxiliary examination, systematic knowledge, scientific research. General practitioners with different degree, titles and working place had different needs, and the differences were statistically significant (P < 0.05). Conclusion At present, the general practitioners has great demand of continuing medical education training, and a strong willingness to do so. There are differences in the needs of general practitioners from different backgrounds for continuing education training content. It is recommended to adjust the training content, establish targeted thinking, implement precise training, meet the needs of general practitioners with different educational backgrounds, professional titles, and work locations, in order to improve the efficiency of training. It is recommended to strengthen the innovation of training models and increase the implementation of online training.
- Sichuan Province /
- General practitioners /
- Continuing education /
- Need

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表 1 1 463名研究对象的基本情况

Table 1. Basic information of 1 463 research subjects

基本情况	类别	人数	百分比(%)
性别	男性	455	31.10
	女性	1 008	68.90
年龄(岁)	>18~35	560	38.28
	>35~45	476	32.53
	>45	427	29.19
学历	专科及以下	406	27.75
	本科及以上	1 057	72.25
职称	初级职称	602	41.15
	中级职称	581	39.71
	高级职称	280	19.14
工作地点	基层医疗卫生机构	602	41.15
	综合医院	861	58.85
既往参加继续教育情况	从未参加	56	3.83
	近1年参加	357	24.40
	近3年每年参加	287	19.62
	近5年每年参加	749	51.19
	超过5年未参加	14	0.96

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表 2 不同工作地点、职称、学历全科医生临床技能培训的需求比较[人(%)]

Table 2. Comparison of clinical skills training needs of general practitioners in different working places, professional titles and educational backgrounds[persons (%)]

基本情况	人数	需求人数	心肺复苏	电除颤	临床常用穿刺	气管插管	体格检查	三腔二囊管植入术	清创缝合术
基层医疗卫生机构	602	546(90.70)	301(50.00)	315(52.33)	308(51.16)	280(46.51)	287(47.67)	189(31.40)	147(24.42)
综合医院	861	721(83.74)	385(44.72)	441(51.22)	266(30.89)	378(43.90)	252(29.27)	252(29.27)	168(19.51)
χ²值		14.783	3.973	0.174	61.048	0.975	51.583	0.761	5.048
P值		< 0.001	0.046	0.677	< 0.001	0.324	< 0.001	0.383	0.025
初级职称	602	539(89.53)	308(51.16)	350(58.14)	238(39.53)	322(53.49)	231(38.37)	161(26.74)	147(24.42)
中高级职称	861	728(84.55)	378(43.90)	406(47.15)	301(34.96)	336(39.02)	308(35.77)	280(32.52)	168(19.51)
χ²值		7.579	7.499	17.120	3.188	29.950	1.029	5.613	5.048
P值		0.006	0.006	< 0.001	0.074	< 0.001	0.310	0.018	0.025
专科及以下	406	336(82.76)	196(48.28)	196(48.28)	133(32.76)	154(37.93)	147(36.21)	84(20.69)	63(15.52)
本科及以上	1 057	931(88.08)	490(46.36)	560(52.98)	406(38.41)	504(47.68)	392(37.09)	357(33.77)	252(23.84)
χ²值		7.158	0.433	2.599	4.027	11.270	0.097	23.851	12.029
P值		0.007	0.510	0.107	0.045	0.001	0.755	< 0.001	0.001

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表 3 不同工作地点、职称、学历全科医生辅助检查的培训需求比较[人(%)]

Table 3. Comparison of training needs of general practitioners with different working places, professional titles and educational qualifications for assisted examination [persons (%)]

基本情况	人数	需求人数	心电图与动态血压	X片与CT等影像学	病理报告	超声多普勒	实验室指标
基层医疗卫生机构	602	574(95.35)	462(76.74)	434(72.09)	203(33.72)	350(58.14)	357(59.30)
综合医院	861	770(89.43)	532(61.79)	588(68.29)	371(43.09)	413(47.97)	476(55.28)
χ²值		16.605	36.382	2.430	13.043	14.691	2.333
P值		< 0.001	< 0.001	0.119	< 0.001	< 0.001	0.127
初级职称	602	574(95.35)	455(75.58)	420(69.77)	231(38.37)	343(56.98)	322(53.49)
中高级职称	861	770(89.43)	539(62.60)	602(69.92)	343(39.84)	420(48.78)	511(59.35)
χ²值		16.605	24.865	0.004	0.319	9.538	4.964
P值		< 0.001	< 0.001	0.951	0.572	0.002	0.026
专科及以下	406	357(87.93)	273(67.24)	231(56.90)	119(29.31)	217(53.45)	238(58.62)
本科及以上	1 057	987(93.38)	721(68.21)	791(74.83)	455(43.05)	546(51.66)	595(56.29)
χ²值		11.645	0.127	44.823	23.214	0.378	0.649
P值		< 0.001	0.722	< 0.001	< 0.001	0.539	0.420

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表 4 不同工作地点、职称、学历全科医生的疾病系统知识培训需求比较[人(%)]

Table 4. Comparison of disease system knowledge training needs of general practitioners in different working places, professional titles and educational backgrounds [persons (%)]

基本情况	人数	呼吸与耳鼻喉系统	消化系统	心脑血管系统	内分泌及代谢系统	神经系统	肌肉骨骼系统	泌尿生殖系统	精神心理系统	恶性肿瘤系统	皮肤系统
基层医疗卫生机构	602	315(52.33)	357(59.30)	413(68.60)	350(58.14)	252(41.86)	112(18.60)	203(33.72)	196(32.56)	168(27.91)	168(27.91)
综合医院	861	329(38.21)	371(43.09)	462(53.66)	420(48.78)	280(32.52)	189(21.95)	189(21.95)	357(41.46)	259(30.08)	182(21.14)
χ²值		28.641	37.252	32.924	12.448	13.356	2.428	25.021	11.950	0.810	8.919
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	0.119	< 0.001	0.001	0.368	0.003
初级职称	602	224(37.21)	322(53.49)	357(59.30)	301(50.00)	224(37.21)	126(20.93)	112(18.60)	210(34.88)	154(25.58)	182(30.23)
中高级职称	861	420(48.78)	406(47.15)	518(60.16)	461(53.54)	469(54.47)	175(20.33)	280(32.52)	343(39.84)	273(31.71)	168(19.51)
χ²值		19.250	5.685	0.109	1.781	42.346	0.079	34.977	3.698	6.433	22.372
P值		< 0.001	0.017	0.741	0.182	< 0.001	0.778	< 0.001	0.054	0.011	< 0.001
专科及以下	406	182(44.83)	196(48.28)	259(63.79)	203(50.00)	133(32.76)	84(20.69)	126(31.03)	147(36.21)	133(32.76)	84(20.69)
本科及以上	1 057	462(43.71)	532(50.33)	616(58.28)	567(53.64)	399(37.75)	217(20.53)	266(25.17)	406(38.41)	294(27.81)	266(25.17)
χ²值		0.149	0.496	17.901	1.561	3.156	0.005	5.151	0.606	3.469	3.229
P值		0.699	0.481	< 0.001	0.212	0.076	0.946	0.023	0.436	0.063	0.072

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表 5 不同工作地点、职称、学历全科医生的科研培训需求比较[人(%)]

Table 5. Comparison of research and training needs of general practitioners in different working places, professional titles and educational backgrounds [persons (%)]

基本情况	人数	科研理论基础	常用统计软件及操作	构建科研思路	数据检索	课题基金申报	科研伦理及法规
基层医疗卫生机构	602	231(38.37)	238(39.53)	210(34.88)	161(26.74)	112(18.60)	112(18.60)
综合医院	861	490(56.91)	483(56.10)	539(62.60)	392(45.53)	266(30.89)	294(34.15)
χ²值		48.714	38.884	108.939	53.170	27.926	42.681
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
初级职称	602	322(53.49)	364(60.47)	357(59.30)	301(50.00)	189(31.40)	196(32.56)
中高级职称	861	399(46.34)	357(41.46)	427(49.59)	252(29.27)	189(21.95)	210(24.39)
χ²值		7.240	51.179	13.427	64.766	16.491	11.789
P值		0.007	< 0.001	< 0.001	< 0.001	< 0.001	0.001
专科及以下	406	175(43.10)	168(41.38)	147(36.21)	126(31.03)	49(12.07)	91(22.41)
本科及以上	1 057	546(51.66)	553(52.32)	602(56.95)	427(40.40)	329(31.13)	315(29.80)
χ²值		8.583	14.042	50.532	10.937	55.594	7.984
P值		0.003	< 0.001	< 0.001	< 0.001	< 0.001	0.005

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表 6 授课方式的需求情况[人(%)]

Table 6. The need for teaching methods[persons (%)]

授课方式	人数	百分比(%)
网络授课	1 008	68.90
网络与现场结合	889	60.76
课件结合自学	553	38.80
现场授课	441	30.14

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参考文献(19)

[1]	石菊. 推动分级诊疗, 促进医疗体系运行效率[J]. 经济研究参考, 2022(4): 23-24. https://www.cnki.com.cn/Article/CJFDTOTAL-JJCK202204007.htm SHI J. Promoting hierarchical diagnosis and treatment and promoting the efficiency of medical system[J]. Review of Economic Research, 2022(4): 23-24. https://www.cnki.com.cn/Article/CJFDTOTAL-JJCK202204007.htm
[2]	李莉蓉. 国内外全科医学教育发展现状与展望[J]. 高教学刊, 2021(7): 31-34. https://www.cnki.com.cn/Article/CJFDTOTAL-GJXK202107008.htm LI L R. Current Situation and Prospect of General Medicine Education at Home and Abroad[J]. Journal of Higher Education, 2021(7): 31-34. https://www.cnki.com.cn/Article/CJFDTOTAL-GJXK202107008.htm
[3]	谷光宇, 李福旺, 严春杰, 等. 线上线下互动教学联合三维质量理论互评在全科医师规培中的应用研究[J]. 中华医学教育探索杂志, 2022, 21(7): 910-914. GU G Y, LI F W, YAN C J, et al. Application of online and offline interactive teaching combined with three-dimensional quality theory mutual evaluation in the standardized residency training of general practitioners[J]. Chinese Journal of Medical Education Research, 2022, 21(7): 910-914.
[4]	龙勇, 黄爱群, 陈芳, 等. 原位模拟联合标准化病人教学法在全科住院医师规范化培训中的应用效果[J]. 保健医学研究与实践, 2022, 19(4): 138-140. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202204034.htm LONG Y, HUANG A Q, CHEN F, et al. Effects of in situ simulation combined with standardized patient method in standardized training of general practice residents[J]. Health Medicine Research and Practice, 2022, 19(4): 138-140. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202204034.htm
[5]	邢桂枚, 严汪龙, 阮三平. 安徽省全科医学师资培训效果评价与分析[J]. 安徽医学, 2019, 40(3): 336-338. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX201903032.htm XING G M, YAN W L, RUAN S P. Evaluation and analysis of training effect of general practice teachers in Anhui province[J]. Anhui Medical Journal, 2019, 40(3): 336-338. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX201903032.htm
[6]	国家卫生健康委员会. 2021中国卫生健康统计年鉴[M]. 北京: 中国协和医科大学出版社, 2021. National Health Commission. 2021 China Health Statistics Yearbook[M]. Beijing: Pekinhg Union Medical College Press, 2021.
[7]	刘妍萌, 孔霞, 杨旭, 等. 我国三地区基层全科医生对继续教育评价的研究[J]. 中国社区医师, 2022, 38(6): 157-159. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYS202206054.htm LIU Y M, KONG X, YANG X, et al. Study of Continuing Education Evaluation by Primary General Practitioners in Three Regions of China[J]. Chinese Community Doctors, 2022, 38(6): 157-159. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYS202206054.htm
[8]	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. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYY202201017.htm 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. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYY202201017.htm
[9]	邵涵, 孙菊梅, 逄玥, 等. 国内外全科医生继续教育研究可视化对比分析[J]. 现代预防医学, 2022, 49(11): 2107-2112. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202211035.htm SHAO H, SUN J M, PANG Y, et al. Visual comparative analysis of continuing education research for general practitioners at home and abroad[J]. Modern Preventive Medicine, 2022, 49(11): 2107-2112. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202211035.htm
[10]	REIS T, FARIA I, SERRA H, et al. Barriers and facilitators to implementing a continuing medical education intervention in a primary health care setting[J]. BMC Health Serv Res, 2022, 22(1): 638-638.
[11]	任文, 叶康丽, 刘颖, 等. 运用德尔菲法构建全科医学专业学位研究生培养体系的研究[J]. 中华医学教育探索杂志, 2022, 21(4): 398-401. REN W, YE K L, LIU Y, et al. Application of Delphi method in constructing the cultivation system of professional postgraduate medical students[J]. Chinese Journal of Medical Education Research, 2022, 21(4): 398-401.
[12]	郑小龙, 刘冬莹, 赵承梅, 等. 天津市全科医生继续医学教育现状与需求调研分析[J]. 继续医学教育, 2018, 32(7): 8-9. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY201807006.htm ZHENG X L, LIU D Y, ZHAO C M, et al. Research on the Continuing Medical Education Status and Demands of General Practitioner in Tianjin[J]Continuing Medical Education, 2018, 32(7): 8-9. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY201807006.htm
[13]	寿涓, 祝墡珠. 新冠肺炎疫情下, 对全科医学毕业后教育的思考[J]. 中国毕业后医学教育, 2020, 4(2): 133-135, 149. https://www.cnki.com.cn/Article/CJFDTOTAL-BHYJ202002012.htm SHOU J, ZHU S Z. Reflections on post-graduate education of general practice amid COVID-19[J]. Chinese Journal of Graduate Medical Education, 2020, 4(2): 133-135, 149. https://www.cnki.com.cn/Article/CJFDTOTAL-BHYJ202002012.htm
[14]	KASHORA F K, CHARLES D-A. Online-Learning: exploring practices among foundation doctors[J]. J Adv Med Educ Prof, 2019, 7(1): 14-19.
[15]	杨慧敏, 尹德卢, 辛倩倩, 等. 我国基层全科医生队伍现状和继续医学教育内容需求分析[J]. 中华全科医学, 2018, 16(10): 1591-1594. doi: 10.16766/j.cnki.issn.1674-4152.000433 YANG H M, YIN D L, XIN Q Q, et al. Current situation of primary general practitioners and demand on continuing medical education content in China[J]. Chinese Journal of General Practice, 2018, 16(10): 1591-1594. doi: 10.16766/j.cnki.issn.1674-4152.000433
[16]	陆萍, 石玉霜, 李艳, 等. 上海市浦东新区全科医生执业后继续教育现状及需求分析[J]. 中华全科医师杂志, 2021, 20(9): 965-971. LU P, SHI Y S, LI Y, et al. The status quo of continuing education and training needs amomg general practitioners in Pudong New Area of Shanghai[J]. Chinese Journal of General Practitioners, 2021, 20(9): 965-971.
[17]	韦红玉, 温亚萍. 1997—2020年国际心理健康素养研究热点演进趋势分析[J]. 教育观察, 2021, 10(47): 1-4, 39. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGN202147001.htm WEI H Y, WEN Y P. Analysis on the evolution trend of international mental health literacy research hotspots from 1997 to 2020[J]. Educational Observation, 2021, 10(47): 1-4, 39. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGN202147001.htm
[18]	张宴萍, 曾庆枝, 何燕玲, 等. 上海9家社区卫生服务中心家庭医生心理卫生知识调查[J]. 中国初级卫生保健, 2020, 34(3): 71-74. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW202003021.htm ZHANG Y P, ZENG Q Z, HEY L, et al. Investigation on Mental Health Knowledge of Family Doctors in 9 Community Health Service Centers in Shanghai[J]. Chinese Primary Health Care, 2020, 34(3): 71-74. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW202003021.htm
[19]	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. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYY202201017.htm 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. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYY202201017.htm