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全科住院医师兼职培训:患病率及相关性的横断面分析。

General practice registrars training part-time: a cross-sectional analysis of prevalence and associations.

机构信息

General Practice Training Tasmania (GPTT), Hobart, Australia.

School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia.

出版信息

Educ Prim Care. 2023 Sep-Nov;34(5-6):244-253. doi: 10.1080/14739879.2023.2248943. Epub 2023 Sep 6.

Abstract

While GPs are working fewer clinical hours and many GP trainees (registrars) do not foresee themselves working full-time in clinical practice, little is known of the epidemiology of registrars training part-time. We aimed to establish the prevalence of general practice part-time training (PTT), and part-time registrars' characteristics and practice patterns. A cross-sectional analysis was conducted of data from the Registrar Clinical Encounters in Training project, an ongoing cohort study of Australian GP registrars' clinical experiences over 60 consecutive consultations in each of three training terms. Univariable and multivariable logistic regression analyses were conducted with the outcome 'training part-time'. 1790 registrars contributed data for 4,135 registrar-terms and 241,945 clinical encounters. Nine hundred and twenty-two registrar-terms (22%, 95%CI:21%-24%) and 52,339 clinical encounters (22%, 95%CI:21%-22%) involved PTT. Factors associated with PTT were registrar characteristics - female gender, older age, in a later training stage, performing other regular medical work; practice characteristics - working in a higher socioeconomic status area; and patient characteristics - seeing more patients new to the registrar and seeing more patients from a non-English-speaking background. No consultation or consultation action factors were significantly associated with PTT. Registrars, practices, and patient associations have GP training implications. The lack of registrar consultation or consultation action associations suggests there may be limited impact of PTT on patient care.

摘要

虽然全科医生的临床工作时间减少了,而且许多全科医生培训生(注册医生)预计自己不会全职从事临床工作,但关于兼职培训注册医生的流行病学情况知之甚少。我们旨在确定普通科医生兼职培训(PTT)的流行率,以及兼职注册医生的特征和实践模式。对 Registrar Clinical Encounters in Training 项目的数据进行了横断面分析,该项目是一项正在进行的澳大利亚全科医生培训生临床经验队列研究,在三个培训学期中,每位培训生连续 60 次就诊都要记录。采用单变量和多变量逻辑回归分析,以“培训兼职”为结果。1790 名培训生提供了 4135 个培训期和 241945 次就诊的数据。922 个培训期(22%,95%CI:21%-24%)和 52339 次就诊(22%,95%CI:21%-22%)涉及 PTT。与 PTT 相关的因素包括培训生特征 - 女性、年龄较大、处于较晚的培训阶段、从事其他常规医疗工作;实践特征 - 在较高社会经济地位的地区工作;以及患者特征 - 看到更多新到培训生的患者和更多来自非英语背景的患者。没有咨询或咨询行动因素与 PTT 显著相关。培训生、实践和患者之间存在全科医生培训方面的关联。缺乏注册医生咨询或咨询行动方面的关联表明,PTT 对患者护理的影响可能有限。

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