McKinstry B, Dodd M, Baldwin P
Lister Postgraduate Institute, Edinburgh, UK; Working Minds Research, Edinburgh, UK.
Med Educ. 2001 Jun;35(6):596-602. doi: 10.1046/j.1365-2923.2001.00914.x.
These were: to describe the implementation of a scheme to extend the general practice registrar component of vocational training to 18 months in Scotland; to determine the effect of the additional attachment on registrars' confidence and skill deficits, and compare changes in these parameters with a control group of registrars who did not extend their training, and to determine whether trainers required a different training style for experienced registrars.
35 registrars extending their training, their trainers, and 39 controls who did not extend their training.
Scottish training practices.
Pre-attachment and post-attachment questionnaires for registrars, triangulated by semistructured telephone interviews, and post-attachment questionnaires for trainers.
Extended attachments were popular with registrars and with trainers, who felt they should be a normal part of training. Registrars with extended training declared themselves to have increased in confidence and addressed skill deficits better than controls. Projects completed were assessed as being of high quality. Trainers found 10% of registrars to have a remediable, important deficit in their skills.
Extended attachments appear to improve registrar confidence and to address knowledge deficits. However, only a minority of registrars had important remediable knowledge deficits and while such attachments may be desirable they may not be essential for most registrars. Overall the outcome appears to have been positive, and supports those who have argued for a change in the proportion of time spent in general practice training, but the scheme is expensive and it is difficult to set a value on what has been gained. Future schemes should have clear training objectives and be tailored towards these.
这些目的包括：描述一项将苏格兰职业培训中的全科医生注册实习部分延长至18个月的计划的实施情况；确定额外实习对注册实习医生信心和技能缺陷的影响，并将这些参数的变化与未延长培训时间的注册实习医生对照组进行比较；确定培训师对经验丰富的注册实习医生是否需要不同的培训方式。
35名延长培训时间的注册实习医生、他们的培训师以及39名未延长培训时间的对照组人员。
苏格兰的培训机构。
对注册实习医生进行实习前和实习后的问卷调查，并通过半结构化电话访谈进行三角验证，同时对培训师进行实习后问卷调查。
延长实习受到注册实习医生和培训师的欢迎，他们认为这应该是培训的正常组成部分。接受延长培训的注册实习医生表示自己的信心有所增强，并且在解决技能缺陷方面比对照组做得更好。完成的项目被评估为高质量。培训师发现10%的注册实习医生在技能方面存在可补救的重大缺陷。
延长实习似乎能提高注册实习医生的信心并解决知识缺陷。然而，只有少数注册实习医生存在重大的可补救知识缺陷，虽然这种实习可能是可取的，但对大多数注册实习医生来说可能并非必不可少。总体而言，结果似乎是积极的，支持了那些主张改变全科医生培训时间比例的人，但该计划成本高昂，且很难对所获得的成果进行价值评估。未来的计划应该有明确的培训目标，并针对这些目标进行调整。
