Crawley H S, Levin J B
Department of Applied Statistics, University of Reading.
BMJ. 1990 Apr 7;300(6729):911-5. doi: 10.1136/bmj.300.6729.911.
(a) To compare current vocational training in general practice with that ascertained by a survey in 1980; (b) to compare the training of trainees in formal training schemes with that of trainees arranging their own hospital and general practice posts.
National questionnaire survey of United Kingdom and armed services trainees who were in a training practice on 1 April 1989. Questionnaires were distributed by course organisers.
Research project set up after an ad hoc meeting of trainees at the 1988 national trainee conference.
2132 Of the 2281 trainees (93%) known to be in a training practice on 1 April 1989.
1657 Trainees returned the questionnaires, representing 73% of all trainees known to be in a training practice on 1 April 1989. Between 1980 and 1989 there were significant improvements in the trainee year, and there was also evidence of improvements in general practice study release courses. There was no evidence of improvement in other aspects of training. General practice trainees spent an average of three years in junior hospital posts, which provided very little opportunity for study related to general practice. Training received during tenure of hospital posts differed significantly between trainees in formal schemes and those arranging their own hospital posts. During the trainee year training was almost the same for those in formal schemes and those arranging their own posts. Regions varied significantly in virtually all aspects of general practice training.
The trainee year could be improved further by enforcing the guidelines of the Joint Committee on Postgraduate Training for General Practice. The poor training in junior hospital posts reflected the low priority that training is generally given during tenure of these posts. A higher proportion of general practice trainees should be attached to vocational training schemes. More hospital trainees could attend general practice study release courses if these were designed specifically with the needs of hospital doctors in mind.
(a)将当前全科医学职业培训与1980年一项调查所确定的情况进行比较;(b)比较参加正规培训计划的学员与自行安排医院和全科医学实习岗位的学员的培训情况。
对1989年4月1日正在进行培训实习的英国及军队学员进行全国问卷调查。问卷由课程组织者分发。
在1988年全国学员会议上学员临时会议后设立的研究项目。
已知在1989年4月1日正在进行培训实习的2281名学员中的2132名(93%)。
1657名学员返回了问卷,占已知在1989年4月1日正在进行培训实习的所有学员的73%。1980年至1989年间,学员年度有显著改善,全科医学学习释放课程也有改善迹象。培训的其他方面没有改善迹象。全科医学学员在初级医院岗位平均待三年,这几乎没有提供与全科医学相关学习的机会。正规培训计划的学员与自行安排医院岗位的学员在医院岗位任职期间接受的培训有显著差异。在学员年度,正规培训计划的学员与自行安排岗位的学员的培训几乎相同。在全科医学培训的几乎所有方面,各地区差异显著。
通过执行全科医学研究生培训联合委员会的指导方针,学员年度可以进一步改善。初级医院岗位培训不佳反映出这些岗位任职期间培训总体上不受重视。应让更高比例的全科医学学员参加职业培训计划。如果全科医学学习释放课程是专门根据医院医生的需求设计的,更多医院学员可以参加这些课程。