Department of General Practice and Family Medicine, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.
BMC Prim Care. 2024 Aug 15;25(1):306. doi: 10.1186/s12875-024-02533-y.
To address the declining numbers of general practitioners (GPs) in rural areas and a lack of medical students pursuing a career in primary care, a general practice-based curriculum coupled with additional university admissions for students has been established at three universities in Hesse, Germany. This study aims to analyze potential topics which students striving to become a GP will benefit from. Teaching such topics will prepare them for their chosen career and working in rural areas. We aimed to explore the views of both specialists and GPs on chief topics and necessary skills in primary care.
In our study we used semi-structured interviews with outpatient specialists and specialists in clinical practice and semi-structured group interviews with GPs in training. The topic guide addressed contents of the curriculum for medical students with an extracurricular focus (addressing additional topics) on primary care. Data analysis was carried out using qualitative content analysis according to Mayring.
GPs in training and specialists agreed on the importance of knowledge in the fields of medical history, physical examination, communication as well as common diseases in primary care. Essential competences mentioned were: inducing medical treatment, decision-making and triage, conducting structured conversations, having patient knowledge (hard skills) as well as an interest in continuous learning, empathy, personal commitment, listening and down-to-earthness (soft skills). Case reports, symptom-based learning, practical training, lessons with simulated patients and the integration of role models were regarded as useful teaching methods.
General practice-based curriculums should not only focus on the transfer of knowledge. Equally important is the training of soft and hard skills to prepare future GPs for their work in primary care. Special teaching methods as well as practical training should be the heart of a newly established curriculum.
为了解决农村地区全科医生数量下降以及缺乏选择从事初级保健职业的医学生的问题，德国黑森州的三所大学建立了以全科为基础的课程，并为学生提供了额外的大学入学名额。本研究旨在分析立志成为全科医生的学生将从中受益的潜在课题。教授这些课题将使他们为自己选择的职业和在农村地区工作做好准备。我们旨在探讨专家和全科医生对初级保健主要课题和必要技能的看法。
在我们的研究中，我们使用了半结构化访谈，访谈对象是门诊专家和临床实践专家，以及培训中的全科医生。主题指南涉及有课外重点（解决额外课题）的医学生课程内容，重点是初级保健。数据分析采用根据 Mayring 的定性内容分析法进行。
培训中的全科医生和专家都认为医学史、体检、沟通以及初级保健中常见疾病等领域的知识很重要。提到的基本能力包括：诱导治疗、决策和分诊、进行结构化对话、具备患者知识（硬技能）以及对持续学习、同理心、个人承诺、倾听和务实的兴趣（软技能）。病例报告、基于症状的学习、实践培训、与模拟患者的课程以及角色模型的整合被认为是有用的教学方法。
以全科为基础的课程不仅应注重知识的传授。同样重要的是培训软技能和硬技能，使未来的全科医生为在初级保健领域的工作做好准备。特殊的教学方法和实践培训应该是新开设课程的核心。
