Institute of Family Medicine and General Practice, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany.
Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany.
BMC Med Educ. 2022 Mar 26;22(1):205. doi: 10.1186/s12909-022-03273-2.
Many residents are exposed to negative attitudes towards primary care during hospital training. Attractive add-on training programs exist, but it is unclear whether these need to be tailored to the location of training (hospital vs. office). We report differences in learner attitudes from a large German add-on training program.
Between 2017 and 2020, a regional network offered 31 quarterly seminars to primary care residents. The seminars addressed medical content, practice management and mentoring. We elicited participants' satisfaction, perceived topic relevance, preferences for future seminars, work situation and employer support for participation. A proportionate odds model was used to assess predictors of ratings; results were stratified by training location (hospital vs. office).
Most respondents were female (380/575 = 70.0%), aged between 26 and 40 (80.8%), and had on average 3.54 ± 1.64 years of residency training. The majority (83.8%) was working in an office and full-time (63.0%). Overall evaluations were positive (very satisfactory 72.1%). Comparing residents in the hospital phase vs. the office phase, overall seminar ratings of the perceived impact on the motivation for primary care did not differ (p = 0.73 vs. 0.18, respectively). Hospital-based residents were less likely to rate the topics as relevant (39.4% vs. 55.7%, p = 0.02) and had different preferences for future seminar topics (top 3: palliative care, emergencies and chronic care vs. billing, disease management and practice finances for hospital and office phase, respectively).
Keeping primary care residents motivated may require education tailored to training location. Our findings may be of interest to teachers, administrators and policymakers.
许多住院医师在医院培训期间接触到对初级保健的负面态度。有一些吸引人的附加培训项目，但尚不清楚这些项目是否需要根据培训地点（医院与办公室）进行调整。我们报告了来自德国大型附加培训计划的学习者态度差异。
在 2017 年至 2020 年期间，一个区域网络为初级保健住院医师提供了 31 个季度研讨会。这些研讨会涉及医学内容、实践管理和指导。我们征求了参与者的满意度、感知主题相关性、对未来研讨会的偏好、工作情况以及雇主对参与的支持。使用比例优势模型评估评分的预测因素；结果按培训地点（医院与办公室）进行分层。
大多数受访者为女性（380/575=70.0%），年龄在 26 至 40 岁之间（80.8%），平均接受了 3.54±1.64 年的住院医师培训。大多数人（83.8%）在办公室全职工作（63.0%）。整体评价是积极的（非常满意 72.1%）。与医院阶段的住院医师相比，办公室阶段的住院医师对初级保健动机的感知影响总体评价没有差异（分别为 0.73 与 0.18，p=0.73）。医院基础的住院医师认为主题相关性较低（39.4%与 55.7%，p=0.02），对未来研讨会主题的偏好也不同（前 3 名：姑息治疗、紧急情况和慢性病，与医院和办公室阶段的计费、疾病管理和实践财务分别相对应）。
保持初级保健住院医师的积极性可能需要根据培训地点调整教育内容。我们的研究结果可能会引起教师、管理人员和决策者的兴趣。
