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探索医师继续职业发展的需求和可能性——以中国基层医疗环境为例的探索性定性研究。

Exploring the needs and possibilities of physicians' continuing professional development - An explorative qualitative study in a Chinese primary care context.

机构信息

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden.

出版信息

PLoS One. 2018 Aug 16;13(8):e0202635. doi: 10.1371/journal.pone.0202635. eCollection 2018.

Abstract

BACKGROUND

One component of the 2009 Chinese health care reform plan is to train general practitioners to improve the delivery of primary care services. This continuing professional development is expected to further improve the physicians' competencies to be general practitioners in primary care. Augmented reality-a combination of virtual information and the real environment-may enhance general practitioners' continuing professional development by allowing their learning experiences to overlap with their workplace practice.

OBJECTIVE

To explore the needs, opportunities, and challenges involved in continuing professional development for Chinese physicians becoming competent general practitioners within primary care, with a special focus on the possibilities of applying augmented reality.

METHODS

This study used a qualitative approach with semi-structured face-to-face interviews. Two managers and thirteen physicians (from four community health centers and stations) participated. The data were analyzed using a thematic inductive analysis approach.

RESULTS

Based on our interviews, most of the physicians were not fully trained as general practitioners but still assumed the duties of that position; they were supposed to eventually become fully trained in line with the reforms of the Chinese primary care system. However, they reported a lack of in-service training opportunities to fulfill this goal. Even those who said that they had such opportunities perceived the efficacy of that training as being poor. The managers and most of the physicians reacted positively to the idea of using augmented reality in continuing professional development, and they suggested antibiotics treatment, surgery, and emergency care as learning areas in which augmented reality could be applied.

CONCLUSIONS

Due to the Chinese reforms of the primary care system, both managers and the physicians themselves expect general practitioners to become qualified by engaging in continuing professional development. Both groups also regarded augmented reality as a potentially useful tool.

摘要

背景

2009 年中国医疗卫生改革计划的一个组成部分是培训全科医生,以改善初级保健服务的提供。这种持续的专业发展预计将进一步提高医生作为初级保健全科医生的能力。增强现实——虚拟信息与真实环境的结合——通过允许医生的学习经验与工作场所实践相重叠,可能会增强全科医生的持续专业发展。

目的

探讨中国医生在初级保健中成为胜任的全科医生的持续专业发展的需求、机会和挑战,特别关注应用增强现实的可能性。

方法

本研究采用半结构化面对面访谈的定性方法。有两位管理者和十三位医生(来自四个社区卫生中心和站)参与了研究。使用主题归纳分析方法对数据进行分析。

结果

根据我们的访谈,大多数医生没有接受过全科医生的全面培训,但仍承担着该职位的职责;他们最终应该按照中国初级保健系统的改革要求接受全面培训。然而,他们报告缺乏在职培训机会来实现这一目标。即使那些表示有此类机会的人也认为这种培训的效果不佳。管理者和大多数医生对在持续专业发展中使用增强现实的想法反应积极,他们建议将抗生素治疗、手术和急救护理作为增强现实可以应用的学习领域。

结论

由于中国初级保健系统的改革,管理者和医生自身都期望全科医生通过参与持续专业发展来获得资格。这两个群体也认为增强现实是一种潜在有用的工具。

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