全科住培医师临床药学知识水平和培训需求调查分析

赵亚子; 蒋品; 黄燕; 刘左元; 方玲

doi:10.16766/j.cnki.issn.1674-4152.003977

全科住培医师临床药学知识水平和培训需求调查分析

doi: 10.16766/j.cnki.issn.1674-4152.003977

赵亚子¹,
蒋品²,
黄燕¹,
刘左元³,
方玲^1, ,

1.
安徽医科大学第一附属医院药剂科，安徽合肥 230032
2.
安徽医科大学第一附属医院全科医学科
3.
北京理工大学马克思主义学院，北京 100081

基金项目:

安徽省高等学校省级教学研究项目 2020jyxm0915

安徽医科大学教学研究项目 2021xjjyxm30

详细信息

通讯作者:
方玲，E-mail：fangling@ahmu.edu.cn

中图分类号: R192.3 R499
计量
- 文章访问数: 1
- HTML全文浏览量: 1
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-02-26
- 网络出版日期: 2025-06-30

Analysis of clinical pharmaceutical knowledge level and training needs among general practice resident physicians

1.
Department of Pharmacy, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, China

摘要

摘要: 目的对医疗卫生机构全科住院医师规范化培训(以下简称住培)医师临床药学知识需求进行调查研究，分析当前全科住培医师在临床药物治疗实践中存在的问题，探讨当前全科住培过程中临床药学教育的欠缺之处及改进方向。方法选取安徽省多地市12家全科住培基地2022—2024年间195名全科住培医师作为研究对象。采用问卷调查法，通过专家调查法和小样本预调查设计问卷，使用“问卷星”在线问卷微信客户端进行填写。主要调查内容分为全科住培医师基本资料、临床用药中常存在的问题、对临床药学服务的认知、临床药学知识培训方法的倾向性4个部分，多维度统计分析当前全科住培医师群体的临床药学知识水平和培训需求。结果共发放196份问卷，回收有效问卷195份。结果显示，全科住培医师在轮转期间接受临床药学知识培训相对不足，对药物不良反应呈报不够重视，对药代动力学/药效学(PK/PD)知识缺乏了解。仅49.23%(96人)的调查对象认为住培是获取用药知识的有效途径之一，88.72%(173人)的全科住培医师表示期望接受临床药学知识培训，具体需求集中在合理用药、特殊人群用药、药物不良反应等方向。结论当前全科住培医师的临床药学知识培训不能满足实际需求，培训过程未做到应培尽培，存在时间限制、单位重视程度不够等问题。急需以实践为导向，建立长效培训体系及考核制度，解决全科住培医师临床用药问题，提高合理用药水平。
- 全科住培医师 /
- 临床药学 /
- 需求调查 /
- 知识培训
Abstract: Objective This study aims to investigate the clinical pharmaceutical knowledge needs of general practice resident physicians in medical institutions, analyze the current problems in their clinical drug therapy practices, and explore the deficiencies and improvement strategies in clinical pharmaceutical education during the residency process. Methods A total of 195 general practice resident physicians from 12 general practice resident training bases in many cities of Anhui Province during 2022 to 2024 were selected as the study objects. Questionnaire survey method was adopted, designed by expert survey method and small sample pre-survey. The questionnaire was filled in through the wechat client of "Wenjuanxing" online questionnaire. The main survey contents of the investigation were divided into the following parts: general information of general resident physicians, common issues in clinical medication, awareness of clinical pharmaceutical services, and preferences for clinical pharmaceutical knowledge training methods, etc. The current clinical pharmaceutical knowledge level and training needs of general resident physicians were analyzed comprehensively and statistically from multiple dimensions. Results A total of 196 questionnaires were distributed, with 195 valid questionnaires collected. The results showed that clinical pharmaceutical knowledge training during rotations was insufficient, and limited attention to adverse drug reaction reporting and pharmacodynamics/pharmacokinetics (PK/PD) knowledge. Only 49.23% (96 people) of the respondents considered the residency process as an effective way to acquire medication knowledge, while 88.72% (173 people) of the general practice resident physicians expressed a strong demand for clinical pharmaceutical knowledge training, particularly in rational drug use, medication for special populations, and adverse drug reactions. Conclusion The current clinical pharmaceutical knowledge training for general practice resident physicians falls short of practical needs, with gaps in coverage, time constraints, and insufficient emphasis from the institutions. It is urgent to establish a practice-oriented long-term training system and assessment system to address the clinical medication issues and improve rational drug use among general practice residents.
- General practice resident physicians /
- Clinical pharmacy /
- Demand survey /
- Knowledge training

HTML全文

表 1 全科住培医师临床常开具药物种类

Table 1. Types of drugs commonly prescribed clinically by general practice residents

基本信息	人数	构成比(%)
呼吸系统用药	167	85.64
解热镇痛抗炎类	156	80.00
消化系统用药	150	76.92
循环系统用药	117	60.00
抗微生物类	108	55.38

下载: 导出CSV

表 2 全科住培医师期望培训内容

Table 2. Training content expectations of general practice resident physicians

培训内容	人数	构成比(%)
合理用药	181	92.82
特殊人群用药	175	89.74
药物不良反应	170	87.18
临床用药的经验交流	149	76.41
中西药联合用药	123	63.08
药品相关法律法规政策	108	55.38

下载: 导出CSV

表 3 全科住培医师希望的考核方式

Table 3. Assessment methods preferred by general practice resident physicians

考核方式	人数	构成比(%)
迷你临床演练评估	62	31.79
访谈带教老师和学员反馈	51	26.15
理论知识考试	41	21.03
病例汇报	37	18.97
其他	4	2.05

下载: 导出CSV

参考文献(20)

[1]	符巧瑜, 陶楚楚, 谢青龙. 我国全科医生培养现状分析与对策[J]. 中医药管理杂志, 2021, 29(3): 136-137. FU Q Y, TAO C C, XIE Q L. Analysis and countermeasures on the current situation of general practitioners training in China[J]. J Tradit Chin Med Manag, 2021, 29(3): 136-137.
[2]	周维钰, 杨德兴, 王强, 等. 云南省鲁甸县居民对全科医学和院前急救相关知识认知现状的问卷调查[J]. 昆明医科大学学报, 2024, 45(3): 118-126. ZHOU W Y, YANG D X, WANG Q, et al. Questionnaire survey on the current status of residents ' knowledge of general practice and prehospital emergency care in Ludian County, Yunnan Province[J]. J Kunming Med University, 2024, 45(3): 118-126.
[3]	国务院办公厅. 国务院办公厅关于改革完善全科医生培养与使用激励机制的意见[EB/OL]. (2018-01-24)[2022-06-12]. http://www.gov.cn/zhengce/content/2018-01/24/content_5260073.htm. General Office of the State Council. Opinions of the General Office of the State Council on Reforming and Improving the Incentive Mechanism for the Training and Utilization of General Practitioners[EB/OL]. (2018-01-24)[2022-06-12]. http://www.gov.cn/zhengce/content/2018-01/24/content_5260073.htm.
[4]	TRELOAR C, SCHROEDER S, LAFFERTY L, et al. Structural competency in the post-prison period for people who inject drugs: a qualitative case study[J]. Int J Drug Policy, 2021, 95: 103261. DOI: 10.1016/j.drugpo.2021.103261.
[5]	楼春蓉, 刘佩华, 倪自暖. 全科医师对多病共存诊疗认知度和需求调查[J]. 中医药管理杂志, 2021, 29(20): 48-49. LOU C R, LIU P H, NI Z N. A survey on general practitioners ' awareness and demand for multi-disease coexistence diagnosis and treatment[J]. J Tradit Chin Med Manag, 2021, 29(20): 48-49.
[6]	邓志玲, 陆益婷, 梁旭健, 等. 基层药师与全科医生团队合作的研究进展、挑战及应对策略[J]. 中国全科医学, 2023, 26(10): 1179-1185. doi: 10.12114/j.issn.1007-9572.2022.0615 DENG Z L, LU Y T, LIANG X J, et al. Research progress, challenges and coping strategies of primary care pharmacists working with general practitioner teams[J]. Chin Gen Pract, 2023, 26(10): 1179-1185. doi: 10.12114/j.issn.1007-9572.2022.0615
[7]	陈运彬, 颜慧恒. 儿童疾病规范化诊治和合理用药的管理思考[J]. 广东医学, 2022, 43(1): 1-4. CHEN Y B, YAN H H. The management of standardized diagnosis and treatment of children ' s diseases and rational use of medication[J]. Guangdong Med J, 2022, 43(1): 1-4.
[8]	许剑, 唐志华. 104例儿童中药注射剂不良反应分析[J]. 儿科药学杂志, 2024, 30(1): 21-23. XU J, TANG Z H. Analysis of 104 cases of adverse reactions to traditional Chinese medicine injections in children[J]. J Pediatr Pharm, 2024, 30(1): 21-23.
[9]	梅洪梁, 戴毅敏, 谢菡, 等. 临床药师在产科的药学咨询服务情况分析[J]. 药学与临床研究, 2020, 28(5): 393-397. MEI H L, DAI Y M, XIE H, et al. Analysis of clinical pharmacists ' pharmacy consultation services in obstetrics[J]. Pharm Clin Res, 2020, 28(5): 393-397.
[10]	卫峻琦, 施芳红, 李浩, 等. 上海某儿童医院门急诊输液药房药品妊娠期及哺乳期用药安全性分析[J]. 中国药师, 2018, 21(5): 853-855. WEI J Q, SHI F H, LI H, et al. Safety analysis of drugs used in pregnancy and lactation in outpatient and emergency infusion pharmacy of a children ' s hospital in Shanghai[J]. Chin Pharm, 2018, 21(5): 853-855.
[11]	艾美玲, 徐超, 龙耀, 等. 妇产科用中成药说明书中妊娠及哺乳期用药标注调查分析[J]. 药品评价, 2023, 20(5): 525-530. AI M L, XU C, LONG Y, et al. Survey and analysis on the labeling of pregnancy and lactation medication in the instruction manual of proprietary Chinese medicines for obstetrics and gynecology[J]. Drug Eval, 2023, 20(5): 525-530.
[12]	闫雪莲, 杜光心, 孙晓红. 老年人合理用药的重要性[J]. 中国临床保健杂志, 2023, 26(5): 718-720. YAN X L, DU G X, SUN X H. The importance of rational drug use in the elderly[J]. Chin J Clin Healthc, 2023, 26(5): 718-720.
[13]	曹新西, 徐晨婕, 侯亚冰, 等. 1990—2025年我国高发慢性病的流行趋势及预测[J]. 中国慢性病预防与控制, 2020, 28(1): 14-19. CAO X X, XU C J, HOU Y B, et al. Trends in the prevalence and prediction of high-prevalence chronic diseases in China from 1990 to 2025[J]. Chin J Prev Control Chronic Dis, 2020, 28(1): 14-19.
[14]	张海英. 药剂科药品不良反应监测管理存在的问题与措施[J]. 中医药管理杂志, 2019, 27(11): 116-117. ZHANG H Y. Problems and measures in monitoring and management of adverse drug reactions in pharmacy[J]. J Tradit Chin Med Manag, 2019, 27(11): 116-117.
[15]	葛君, 宣玲, 沙莎, 等. 翻转课堂联合案例教学法在心内科住院医师规范化培训中的应用[J]. 中华全科医学, 2022, 20(12): 2134-2137. doi: 10.16766/j.cnki.issn.1674-4152.002787 GE J, XUAN L, SHA S, et al. Application of flipped classroom combined with case teaching method in standardized training of cardiology residents[J]. Chin J Gen Pract, 2022, 20(12): 2134-2137. doi: 10.16766/j.cnki.issn.1674-4152.002787
[16]	李亮, 周旺, 张超学, 等. 新形式下基于网络平台的翻转教学模式在超声影像学教学中的应用效果[J]. 中华全科医学, 2021, 19(8): 1386-1389. doi: 10.16766/j.cnki.issn.1674-4152.002067 LI L, ZHOU W, ZHANG C X, et al. Application effect of flipped teaching mode in ultrasonography teaching based on network platform under new form[J]. Chin J Gen Pract, 2021, 19(8): 1386-1389. doi: 10.16766/j.cnki.issn.1674-4152.002067
[17]	许嵩翱, 张玲芳, 郁慧杰. 全科门诊接诊桌和带教方式的改进及其在全科规培医师带教中的应用[J]. 中华全科医学, 2020, 18(3): 488-491. doi: 10.16766/j.cnki.issn.1674-4152.001280 XU S A, ZHANG L F, YU H J. Improvement of receiving table and teaching method in general practice and application in teaching general practitioners[J]. Chin J Gen Pract, 2020, 18(3): 488-491. doi: 10.16766/j.cnki.issn.1674-4152.001280
[18]	李晓红, 袁琳, 陈建欢, 等. Mini-CEX在妇产科见习中的应用探索[J]. 继续医学教育, 2023, 37(7): 157-160. LI X H, YUAN L, CHEN J H, et al. Exploration of the application of mini-CEX in obstetrics and gynecology clerkship[J]. Contin Med Educ, 2023, 37(7): 157-160.
[19]	荣道香, 方姗姗, 周瑞, 等. 联合应用Mini-CEX和DOPS在儿科实习医师教学评估中的价值[J]. 中华全科医学, 2022, 20(11): 1944-1946, 1994. doi: 10.16766/j.cnki.issn.1674-4152.002742 RONG D X, FANG S S, ZHOU R, et al. The value of combining mini-CEX and DOPS in teaching assessment of pediatric interns[J]. Chin J Gen Pract, 2022, 20(11): 1944-1946, 1994. doi: 10.16766/j.cnki.issn.1674-4152.002742
[20]	杨凯超, 李开军, 吴伟东, 等. 全科住院医师规范化培训基地教学门诊开展现状调查[J]. 浙江医学教育, 2023, 22(4): 225-230. YANG K C, LI K J, WU W D, et al. A survey on the current status of teaching clinics in general practice residency standardized training bases[J]. Zhejiang Med Educ, 2023, 22(4): 225-230.