Shao Shuang, Wu Tao, Guo Aimin, Jin Guanghui, Chen Rui, Zhao Yali, Du Juan, Lu Xiaoqin
School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China.
Department of Scientific Research, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
BMC Fam Pract. 2018 Nov 28;19(1):182. doi: 10.1186/s12875-018-0867-6.
The Chinese government offered various types of training programs for strengthening the role of doctors working in community health service institutions (CHSIs). The study intended to investigate the current training programs and training needs of doctors nationally in urban CHSIs in China, and to provide propositions for training more qualified doctors in the future.
Total 3098 doctors in 192 urban CHSIs were chosen from 9 provinces (Hebei, Liaoning, Shandong, Zhejiang, Fujian, Hunan, Guangxi, Guizhou, Ningxia) and one municipality (Beijing) among 31 provinces in eastern, central, and western regions by stratified sampling methods in Mainland China. All doctors in the selected CHSIs were investigated in this study. We discharged 3073 questionnaires, and the response rate was 98.0%. Descriptive statistics were used to describe the characteristics, training contents, problems and needs of doctors. Differences in training contents, problems and needs between eastern, central and western regions were analyzed with chi-square tests.
49.3% of doctors in CHSIs had Bachelor's degree and beyond. 12.9% of doctors had senior professional titles. The most frequent training topics for the doctors in eastern, central and western regions were "basic clinical theory knowledge" (52.4%), "community health service competency" (59.6%), "clinical practice skills" (45.9%) respectively. The most serious problem for doctors was "insufficient training time" in eastern (36.8%), central (36.5%) and western (39.6%). The biggest knowledge need for doctors both in eastern (79.8%) and central region (79.1%) was "the updated international medical knowledge", in western region it was "the updated domestic medical knowledge" (73.2%). The biggest skill-related training need for doctors in eastern region (84.1%) and central region (82.6%) was "communication skills", and "diagnosis and differential diagnosis" in western region (78.2%).
Government should design proper training contents according to the knowledge and skill needs of different design. Furthermore, a uniform, rigorous training and evaluation system focus on practicability should be established to promote community health service system in Mainland China.
中国政府提供了各类培训项目，以强化在社区卫生服务机构工作的医生的作用。本研究旨在调查中国城市社区卫生服务机构医生的当前培训项目及培训需求，并为未来培养更合格的医生提供建议。
通过分层抽样方法，从中国大陆东部、中部和西部31个省中的9个省（河北、辽宁、山东、浙江、福建、湖南、广西、贵州、宁夏）和1个直辖市（北京）的192家城市社区卫生服务机构中选取了3098名医生。本研究对所选社区卫生服务机构的所有医生进行了调查。我们发放了3073份问卷，回复率为98.0%。采用描述性统计来描述医生的特征、培训内容、问题和需求。使用卡方检验分析东部、中部和西部地区在培训内容、问题和需求方面的差异。
社区卫生服务机构中49.3%的医生拥有本科及以上学历。12.9%的医生拥有高级职称。东部、中部和西部地区医生最常接受培训的主题分别是“基础临床理论知识”（52.4%）、“社区卫生服务能力”（59.6%）、“临床实践技能”（45.9%）。医生面临的最严重问题在东部地区是“培训时间不足”（36.8%），中部地区是“培训时间不足”（36.5%），西部地区是“培训时间不足”（39.6%）。东部地区（79.8%）和中部地区（79.1%）医生最大的知识需求是“更新的国际医学知识”，西部地区是“更新的国内医学知识”（73.2%）。东部地区（84.1%）和中部地区（82.6%）医生最大的技能相关培训需求是“沟通技巧”，西部地区是“诊断与鉴别诊断”（78.2%）。
政府应根据不同地区的知识和技能需求设计合适的培训内容。此外，应建立一个统一、严格且注重实用性的培训与评估体系，以促进中国大陆的社区卫生服务体系发展。
