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在初级医疗中时间更长:一项关于威尔士全科医生培训模式的混合方法研究。

Longer in primary care: a mixed-methods study of the Welsh GP training model.

作者信息

Cserzo Dorottya, Bullock Alison

机构信息

Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, Cardiff, UK

Cardiff Unit for Research and Evaluation in Medical and Dental Education, School of Social Sciences, Cardiff University, Cardiff, UK.

出版信息

BJGP Open. 2024 Apr 25;8(1). doi: 10.3399/BJGPO.2023.0159. Print 2024 Apr.

Abstract

BACKGROUND

A new model of GP training was introduced in Wales, whereby trainees spend 1 year in hospital and 2 years in general practice (the 1+2 model), a change from the previous model of 18 months in each setting.

AIM

To evaluate the 1+2 model of GP training in Wales.

DESIGN & SETTING: Longitudinal mixed-methods evaluation via repeated surveys and focus groups with GP trainers and trainees across the Welsh training schemes.

METHOD

Yearly surveys and focus groups were undertaken between June 2020 and December 2022. Quantitative survey data were analysed in SPSS. Qualitative survey data and focus group transcripts were analysed thematically.

RESULTS

Spending more time in general practice was seen as a major benefit. The consensus was that general practice is the best place to learn essential consultation skills. Furthermore, general practice was viewed as a flexible educational setting where knowledge gaps can be addressed. The main concern about the 1+2 model was that trainees would miss experience of key specialties. However, as trainees progressed through the training programme, this concern diminished. All trainees and most trainers thought that the benefits of the 1+2 model outweighed drawbacks.

CONCLUSION

Spending more time in general practice during GP training appears to improve how prepared trainees felt for practice. Future changes should explore options to enhance hospital experience without reducing time spent in general practice.

摘要

背景

威尔士引入了一种新的全科医生培训模式,即学员在医院实习1年,在全科医疗实习2年(1+2模式),这与之前在每种环境下实习18个月的模式有所不同。

目的

评估威尔士的1+2全科医生培训模式。

设计与背景

通过对威尔士培训计划中的全科医生培训师和学员进行重复调查和焦点小组讨论,进行纵向混合方法评估。

方法

在2020年6月至2022年12月期间进行年度调查和焦点小组讨论。定量调查数据在SPSS中进行分析。定性调查数据和焦点小组记录进行主题分析。

结果

在全科医疗中花费更多时间被视为一项主要益处。大家一致认为,全科医疗是学习基本诊疗技能的最佳场所。此外,全科医疗被视为一个灵活的教育环境,在那里可以弥补知识差距。对1+2模式的主要担忧是学员会错过关键专科的经验。然而,随着学员在培训计划中的进展,这种担忧有所减少。所有学员和大多数培训师都认为1+2模式的好处大于弊端。

结论

在全科医生培训期间在全科医疗中花费更多时间似乎能提高学员对执业的准备程度。未来的变革应探索在不减少全科医疗实习时间的情况下增强医院实习经验的选项。

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