Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
Int J Environ Res Public Health. 2022 May 6;19(9):5676. doi: 10.3390/ijerph19095676.
The Standardized Residency Training Program (SRTP) is a significant initiative to deepen health systems and medical education in developing countries like China. Despite the promotion of the SRTP nationwide and its implementation with various improvements, Chinese continuous medical education is still in its infancy. Compared with the residents, little is known about clinical teachers under the SRTP in China. However, clinical teachers effectively determine the training quality as critical disseminators of knowledge, skills, and values in medical practice. Thus, the study aims to analyze critical factors affecting their cognitive job satisfaction and provide continuous improvements for SRTP.
From 1 December 2018 to 31 May 2019, we conducted a self-designed questionnaire with 13 SRTPs (including both training bases and professional bases) in Shaoxing city to evaluate clinical teachers' satisfaction. Altogether, 574 clinical teachers responded to the survey expressing generally high overall satisfaction. We adopted a Chi-square test and Fisher's Exact Test to evaluate the single impact factors affecting the satisfaction of clinical teachers. The multiple factors analysis applied the logistic regression model.
The male clinical teachers had significant differences in satisfaction with the teaching content (OR: 0.675, [95% CI: 0.4770.953]), conflicts between study and work (OR: 0.542, [95%CI: 0.3710.791]), the attention of leaders (OR: 0.403, [95%CI: 0.2520.645]), and the subsidies of teachers (OR: 0.527, [95%CI: 0.3470.805]). Compared with internal medicine, clinical teachers from surgery (OR: 2.396, [95%CI: 1.365-4.206]) and other departments (OR: 2.409, [95%CI: 1.406-4.129]) were more satisfied when they considered that residents have high motivation to attend training. In addition, compared with the attending physicians, the deputy chief physicians (OR: 0.493, [95%CI: 0.310-0.783]) and the chief physicians (OR: 0.683, [95%CI: 0.471-0.991]) disagreed more regarding the residents' wage being good enough.
Clinical teachers widely recognize the SRTP. However, teachers' satisfaction varied due to different genders, working departments, and professional titles. The study also discussed possible reasons and strategy implications behind these findings, which combined unique Chinese society characteristics. Further, we believe the analysis and interpretations remind us of the applications of residency training methods from other Western countries, which should also consider the unique socio-cultural challenges.
标准化住院医师培训计划（SRTP）是深化发展中国家卫生系统和医学教育的重要举措，在中国得到了全面推广，并在实施过程中进行了各种改进，但中国的继续医学教育仍处于起步阶段。与住院医师相比，中国 SRTP 下的临床教师鲜为人知。然而，临床教师作为医学实践中知识、技能和价值观的重要传播者，有效决定了培训质量。因此，本研究旨在分析影响其认知工作满意度的关键因素，并为 SRTP 提供持续改进。
2018 年 12 月 1 日至 2019 年 5 月 31 日，我们采用自行设计的问卷对绍兴市 13 个 SRTP（包括培训基地和专业基地）的临床教师进行满意度评估。共有 574 名临床教师对调查做出回应，总体满意度较高。我们采用卡方检验和 Fisher 精确检验评估单因素对临床教师满意度的影响。多因素分析采用逻辑回归模型。
男性临床教师在教学内容满意度（OR：0.675，[95%CI：0.4770.953]）、学习与工作冲突满意度（OR：0.542，[95%CI：0.3710.791]）、领导关注度满意度（OR：0.403，[95%CI：0.2520.645]）和教师补贴满意度（OR：0.527，[95%CI：0.3470.805]）方面存在显著差异。与内科相比，外科（OR：2.396，[95%CI：1.3654.206]）和其他科室（OR：2.409，[95%CI：1.4064.129]）的临床教师更满意住院医师有较高的培训积极性。此外，与主治医生相比，副主任医师（OR：0.493，[95%CI：0.3100.783]）和主任医师（OR：0.683，[95%CI：0.4710.991]）更不同意住院医师工资足够好。
临床教师普遍认可 SRTP，但由于性别、工作科室和职称不同，教师满意度存在差异。研究还讨论了这些发现背后可能的原因和策略意义，结合了中国独特的社会特征。此外，我们认为分析和解释提醒我们注意从其他西方国家应用住院医师培训方法，这也应考虑到独特的社会文化挑战。
