Gunasekera H, Buckmaster A
Children's Hospital at Westmead, Sydney, Australia.
J Paediatr Child Health. 2004 Sep-Oct;40(9-10):510-6. doi: 10.1111/j.1440-1754.2004.00454.x.
To determine current Australian general paediatrician's perceptions regarding the adequacy of their training particularly in the new morbidity (NM) area (developmental, behavioural and psychosocial). To ascertain if there is a perceived need to change training in this area, the level of support for change and to canvass opinion on how to achieve change.
Australian general paediatricians were surveyed by mail in April 2002. The data obtained from those trained before and after the 1992 changes to training were compared by chi(2) analysis.
The response rate was 76%. More than one in five new referrals were for NM problems according to 62% of the respondents. The majority (67%) of respondents reported that they were poorly or very poorly trained for NM work in contrast to a majority (82%) who rated that they were well or very well trained for general paediatric work (P < 0.001). Respondents believed that they were poorly or very poorly trained in the use of stimulants (74%), selective serotonin reuptake inhibitors (SSRIs) (93%), tricyclic antidepressants (TCAs) (79%) and clonidine (86%), despite a third of scripts being for one of these medications. The majority of all general paediatricians (90%) want changes to advanced training. Seminars/tutorials, organized visits to general paediatricians' rooms and a mandatory 12 month NM term were the most highly supported options for change.
In view of the prevalence of the NM problems, the perception of inadequate training and the overwhelming support for change it is time for new models of training to be developed and tested.
确定当前澳大利亚普通儿科医生对其培训充分性的看法，尤其是在新发病（NM）领域（发育、行为和心理社会方面）。确定在该领域是否存在对培训变革的认知需求、变革的支持程度，并就如何实现变革征求意见。
2002年4月通过邮件对澳大利亚普通儿科医生进行了调查。通过卡方分析比较了1992年培训变革前后接受培训的医生所获得的数据。
回复率为76%。据62%的受访者称，超过五分之一的新转诊病例是关于NM问题的。大多数（67%）受访者表示，他们在NM工作方面的培训很差或非常差，相比之下，大多数（82%）受访者认为他们在普通儿科工作方面的培训良好或非常良好（P<0.001）。尽管三分之一的处方是针对这些药物中的一种，但受访者认为他们在使用兴奋剂（74%）、选择性5-羟色胺再摄取抑制剂（SSRI）（93%）、三环类抗抑郁药（TCA）（79%）和可乐定（86%）方面的培训很差或非常差。所有普通儿科医生中的大多数（90%）希望对高级培训进行变革。研讨会/辅导课、组织参观普通儿科医生的诊室以及为期12个月的强制性NM实习是最受支持的变革选项。
鉴于NM问题的普遍性、对培训不足的认知以及对变革的压倒性支持，是时候开发和测试新的培训模式了。
