Egidi Günther, Bernau Ruben, Börger Matthias, Mühlenfeld Hans-Michael, Schmiemann Guido
General Practitioner, Bremen, Germany ; speaker on medical education DEGAM, Bremen, Germany.
General Practitioner Hambergen nr. Bremen, Bremen, Germany.
GMS Z Med Ausbild. 2014 Feb 17;31(1):Doc8. doi: 10.3205/zma000900. eCollection 2014.
Whilst the structure of primary care vocational training in Germany is being increasingly formalized there remains an abundance of disparate locally defined criteria for the training practices. Advanced medical training in the ambulatory setting has also been identified as an area of need by other specialties.
In contrast to the current practice of a unregulated authorization by regional medical associations this catalogue provide transparent, clearly defined criteria for the assignment of training practice status.
The first draft of the criteria catalogue integrates feedback from 30 academic general practitioners. The feasibility of the catalogue was tested by a further 30 surgeries. Analysis included an assessment of the sociodemographic characteristics of the trainers and their practices as well as satisfaction of the participants with the approved authorization period.
The criteria catalogue comprises 19 items within the domains of trainer qualification, practice infrastructure and patient specific factors as well as mandatory criteria. The points scored through this system confer a variable period of authorization. Of the 30 participants 17 were satisfied with the period of authorization they received, 10 were dissatisfied, and one was indifferent. Satisfaction showed no correlation with sex, experience as a trainer, or with the score achieved through the criteria catalogue. It correlated little with the length of time practicing as a doctor.
The criteria catalogue reflects both the breadth of general practice as well as the skills of the trainers. Satisfaction of participants in the test group was good, and infers a basis for applying the catalogue through regional medical associations to assign teaching practice status. It may also be used as a blue-print for other medical specialties.
尽管德国初级保健职业培训的结构日益正规化，但对于培训实践仍存在大量不同的本地定义标准。门诊环境中的高级医学培训也被其他专业确定为一个需要改进的领域。
与目前由地区医学协会进行无监管授权的做法不同，本目录为培训实践地位的认定提供了透明、明确的标准。
标准目录初稿整合了30名学术全科医生的反馈意见。另外30家诊所对该目录的可行性进行了测试。分析内容包括对培训师及其诊所的社会人口统计学特征的评估，以及参与者对批准的授权期限的满意度。
标准目录包括培训师资格、实践基础设施、患者特定因素以及强制性标准等领域内的19项内容。通过该系统获得的分数赋予不同的授权期限。30名参与者中，17人对他们获得的授权期限感到满意，10人不满意，1人无意见。满意度与性别、培训师经验或通过标准目录获得的分数无关。它与行医时间长短的相关性也很小。
标准目录既反映了全科医疗的广度，也反映了培训师的技能。测试组参与者的满意度良好，这为通过地区医学协会应用该目录来认定教学实践地位提供了依据。它也可作为其他医学专业的蓝本。
