Capewell Sarah, Stewart Kirsty, Bowie Paul, Kelly Moya
General Practitioner and Medical Education Fellow, Glasgow, UK.
Programme Director, Glasgow, UK.
Educ Prim Care. 2014 Jan;25(1):18-25. doi: 10.1080/14739879.2014.11494237.
In 2012 the first Scottish cohort of trainees completed a four-year training programme in general practice. In the same year, the Royal College of General Practitioners (RCGP) successfully made the educational case for lengthening training from three to four years in the rest of the UK. This project sought to evaluate the experiences of the initial four-year cohorts (2012 and 2013) to gain the Certificate of Completion of Training (CCT). We aimed to capture trainees' experiences of the training programme and how well it prepared them for independent general practice. We also investigated whether perceived levels of clinical confidence in key areas of the curriculum improved over time. To achieve this we undertook a cross-sectional online questionnaire survey. Open-ended questions were included to elicit more in-depth responses by participants on all issues. A total of 20/49 trainees in 2012 (40%) and 46/50 trainees in 2013 (92%) completed the survey. Perceived mean levels of clinical confidence in the key curriculum domains surveyed in 2012/13 were generally high, particularly in clinical domains or topics such as cancer management (94%) and paediatrics (94%). It was lowest in non-clinical domains such as GP partnership (57%), practice management (68%) and leadership (65%), but also in some skills specific to general practice that are of importance where healthcare delivery is increasingly community-based such as public health (63%) and caring for the long-term unemployed (33%). This small study will inform the implementation of an integrated, community-based model of training to enable GP trainees to achieve the clinical and generalist skills required in the immediate future.
2012年，首批苏格兰实习医生 cohort 完成了为期四年的全科医学培训项目。同年，皇家全科医师学院（RCGP）成功地在英国其他地区提出了将培训时长从三年延长至四年的教育理由。该项目旨在评估最初的四年 cohort（2012年和2013年）获得培训结业证书（CCT）的经历。我们旨在了解实习医生对培训项目的体验以及该项目为他们独立开展全科医疗工作所做的准备情况。我们还调查了随着时间推移，在课程关键领域中所感知到的临床信心水平是否有所提高。为实现这一目标，我们开展了一项横断面在线问卷调查。问卷中包含开放式问题，以促使参与者就所有问题给出更深入的回答。2012年共有20/49名实习医生（40%）、2013年共有46/50名实习医生（92%）完成了调查。2012/13年所调查的关键课程领域中，所感知到的临床信心平均水平总体较高，尤其是在癌症管理（94%）和儿科（94%）等临床领域或主题方面。在非临床领域，如全科医生合伙关系（57%）、实践管理（68%）和领导力（65%）方面最低，但在一些全科医疗特有的技能方面也较低，这些技能在医疗服务日益以社区为基础的情况下很重要，如公共卫生（63%）和照顾长期失业者（33%）。这项小型研究将为实施基于社区的综合培训模式提供参考，以使全科医学实习医生能够掌握近期所需的临床和通科技能。
