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继续医学教育的障碍:一项针对丹麦全科医生的横断面问卷调查研究

Barriers for continuous medical education: a cross-sectional questionnaire study among Danish GPs.

作者信息

Ibsen Helle, Ahrenfeldt Linda Juel, Lykkegaard Jesper, Søndergaard Jens, Švab Igor, Kjaer Niels Kristian

机构信息

Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark

Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.

出版信息

BJGP Open. 2024 Oct 29;8(3). doi: 10.3399/BJGPO.2023.0228. Print 2024 Oct.

Abstract

BACKGROUND

GPs' participation in continuous medical education (CME) is essential for patient care, GPs' wellbeing, and healthcare expenditure. However, one-quarter of Danish GPs did not use their reimbursement for CME in 2022. Knowledge of barriers for participating in CME is limited.

AIM

To analyse the barriers GPs face to participation in CME, and patterns in perceived barriers.

DESIGN & SETTING: A cross-sectional questionnaire study design was used. The study population comprised all 3257 GPs in Denmark who, in May 2023, were registered as entitled to reimbursement for CME.

METHOD

The response rate was = 1303/3257 (40%). Based on a question about use of CME, the responders were divided into 'frequent', 'partial', and 'seldom' users. Partial and seldom users answered questions about barriers related to CME ( = 726). The presence of barriers was quantified, and a latent class analysis (LCA) was used to stratify GPs according to their barrier patterns.

RESULTS

The most frequent barriers were as follows: too busy (67%); fully booked courses (45%); and no substitute or locum doctor (39%). Based on the LCA, we found three distinctive patterns, clustering around the following: GPs from clinics with no tradition for CME (class 1, 17%); GPs who used time on professional work outside clinic (teaching, organisational work) (class 2, 43%); and GPs who were personally or professionally affected (class 3, 40%). Singled-handed and male GPs were slightly overrepresented among seldom users.

CONCLUSION

We have identified barriers for CME. We found three different profiles of GPs who perceived different patterns of barriers. Identified patterns in barriers should be considered in future CME initiatives.

摘要

背景

全科医生参与继续医学教育(CME)对于患者护理、全科医生的健康以及医疗保健支出至关重要。然而,2022年四分之一的丹麦全科医生未使用继续医学教育报销费用。关于参与继续医学教育的障碍的了解有限。

目的

分析全科医生参与继续医学教育面临的障碍以及感知障碍的模式。

设计与背景

采用横断面问卷调查研究设计。研究人群包括丹麦所有3257名全科医生,他们在2023年5月被登记有权报销继续医学教育费用。

方法

回复率为1303/3257(40%)。根据关于继续医学教育使用情况的问题,回复者被分为“频繁”“部分”和“很少”使用者。部分和很少使用者回答了与继续医学教育相关的障碍问题(n = 726)。对障碍的存在进行量化,并使用潜在类别分析(LCA)根据他们的障碍模式对全科医生进行分层。

结果

最常见的障碍如下:太忙(67%);课程已满员(45%);没有替代医生或临时代理医生(39%)。基于潜在类别分析,我们发现了三种不同模式,集中在以下方面:来自没有继续医学教育传统诊所的全科医生(第1类,17%);将时间用于诊所外专业工作(教学、组织工作)的全科医生(第2类,43%);以及受到个人或职业影响的全科医生(第3类,40%)。很少使用者中,单干的全科医生和男性全科医生的比例略高。

结论

我们确定了继续医学教育的障碍。我们发现了三类不同的全科医生,他们感知到不同的障碍模式。在未来的继续医学教育倡议中应考虑已确定的障碍模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/492a/11523502/fcc327893f6e/BJGPO.2023.0228-f1.jpg

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