Smith L F, Eve R, Crabtree R
East Somerset Research Consortium.
Br J Gen Pract. 2000 Apr;50(453):288-92.
There is no consensus about whether higher professional education (HPE) is necessary for general practitioners (GPs) to complete their vocational training.
To investigate beliefs about the need for HPE, its funding, duration, curriculum, and whether new principals (NPs) are eligible to undertake it.
A confidential postal questionnaire was sent to senior partners, GP registrars, NPs, GP trainers, and GP tutors, principally in the old South West region of England, and nationally to other 'academic' GPs.
Of 1199 GPs, 750 (62.6%) replied; 561 (79.2%) responders agreed with the principle of HPE for NPs, especially members of the Royal College of General Practitioners and academic GPs; senior partners (SPs) were less likely to agree (all P < 0.001). Of 700 GPs, 331 (50.3%) believed that HPE should last one or two years, 66.4% agreed that NPs should have a major input into the HPE curriculum, and 54.6% agreed that health authorities should be major sources of funding, together with the postgraduate deans (29.9%). GP tutors and trainers should have the main responsibility for teaching HPE. The principal barriers to setting up a HPE course are the financial cost, the time cost, difficulty in changing the status quo, and various practical problems. The facilitatory influences are: the enthusiasm of the NPs and of their clinical colleagues, an appropriate educational environment, a high quality clinical base, and recognition that NPs have specific needs. Of 668 GPs, 89.7% would release NPs if an HPE course were free and locums were paid, although SPs were less likely to agree (P < 0.001); if the HPE course cost the practice money, then only 30.6% would release NPs.
If adequately externally funded, then there is widespread support for HPE with most GPs willing to release NPs. NPs and existing GP teachers should decide the curriculum. Its aim should be to provide educational support for NPs during the transition from GP registrar to fully-trained GP principal.
对于全科医生(GP)完成其职业培训是否需要高等专业教育(HPE),目前尚无共识。
调查关于HPE的必要性、资金、时长、课程设置的看法,以及新负责人(NP)是否有资格参加HPE。
向主要位于英格兰旧西南部地区的资深合伙人、GP注册学员、NP、GP培训师和GP导师发送了一份保密的邮政调查问卷,并在全国范围内发送给其他“学术型”GP。
在1199名GP中,750名(62.6%)回复;561名(79.2%)回复者赞同NP接受HPE的原则,尤其是皇家全科医师学院成员和学术型GP;资深合伙人(SP)不太可能赞同(所有P<0.001)。在700名GP中,331名(50.3%)认为HPE应持续一到两年,66.4%赞同NP应在HPE课程设置中发挥主要作用,54.6%赞同卫生当局应与研究生院长(29.9%)一起成为主要资金来源。GP导师和培训师应承担教授HPE的主要责任。开设HPE课程的主要障碍是财务成本、时间成本、改变现状的困难以及各种实际问题。促进因素包括:NP及其临床同事的热情、合适的教育环境、高质量的临床基地以及认识到NP有特定需求。在668名GP中,89.7%表示如果HPE课程免费且临时替班人员有报酬,他们会放行NP,尽管SP不太可能赞同(P<0.001);如果HPE课程让诊所花钱,那么只有30.6%会放行NP。
如果有足够的外部资金支持,那么HPE会得到广泛支持,大多数GP愿意放行NP。NP和现有的GP教师应决定课程设置。其目的应是在NP从GP注册学员过渡到完全培训合格的GP负责人期间提供教育支持。