General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University,, Chengdu, 610041, China.
Department of Primary Health Care, The fourth People's hospital of Dazhu County, Dazhou, 635100, China.
BMC Med Educ. 2024 Jun 19;24(1):679. doi: 10.1186/s12909-024-05647-0.
This study aims to determine the satisfaction and future training needs of general practice residents participating in a novel model of ambulatory teaching aligned with the specifications for standardized residency training in outpatient management issued by the Chinese Medical Doctor Association (CMDA).
A cross-sectional survey of the satisfaction and training needs was conducted among general practice residents at West China Hospital, Sichuan University. Patient characteristics and preceptors' feedback on the residents' performance were also analyzed.
The study involved 109 residents (30.28% men) and 161 patients (34.78% men; age: 52.63 ± 15.87 years). Residents reported an overall satisfaction score of 4.28 ± 0.62 with the ambulatory teaching program. Notably, residents scored lower in the Subjective-Objective-Assessment-Plan (SOAP) evaluation when encountering patients with the greater the number of medical problems (P < 0.001). Residents encountering patients with a shorter duration of illness (< 3 months) achieved higher scores than those with longer illness durations (≥ 3 months, P = 0.044). Residency general practitioners (GPs) were most challenged by applying appropriate and effective patient referrals (43/109; 39.45%). GPs expressed a strong desire to learn how to make decisions when facing challenging patient situations (4.51 ± 0.63).
This study suggests selecting patients with multiple comorbidities for ambulatory teaching and enhancing training on practical problem-solving abilities for GPs. The findings provide insights for the development of future ambulatory teaching programs.
本研究旨在确定参与与中华医学会（CMDA）发布的门诊管理住院医师规范化培训规范相符的新型门诊教学模式的全科住院医师的满意度和未来培训需求。
对四川大学华西医院的全科住院医师进行了满意度和培训需求的横断面调查。还分析了患者特征和带教医生对住院医师表现的反馈。
该研究涉及 109 名住院医师（30.28%为男性）和 161 名患者（34.78%为男性；年龄：52.63±15.87 岁）。住院医师对门诊教学计划的总体满意度评分为 4.28±0.62。值得注意的是，当遇到患有更多医疗问题的患者时，住院医师在主观-客观-评估-计划（SOAP）评估中得分较低（P<0.001）。遇到患病时间较短（<3 个月）的患者的住院医师得分高于患病时间较长（≥3 个月，P=0.044）的住院医师。全科住院医师（GP）在为患者进行适当且有效的转诊方面遇到最大的挑战（43/109；39.45%）。GP 们强烈希望学习在面对具有挑战性的患者情况时如何做出决策（4.51±0.63）。
本研究建议为门诊教学选择患有多种合并症的患者，并加强对 GP 解决实际问题能力的培训。研究结果为未来门诊教学计划的发展提供了参考。
