从全科医学研究生培训开始，轮转全科医学——关于经历和影响的定性研究。
Starting postgraduate medical training in general practice with a rotation in general practice - a qualitative study on experiences and effects.
作者信息
Becker Christine, Stengel Sandra, Roos Marco, Altiner Attila, Schwill Simon
机构信息
University Hospital Heidelberg, Department of General Practice and Health Services Research, Heidelberg, Germany.
University of Augsburg, Faculty of Medicine, Department of General Practice, Augsburg, Germany.
出版信息
GMS J Med Educ. 2024 Nov 15;41(5):Doc53. doi: 10.3205/zma001708. eCollection 2024.
OBJECTIVE
In Germany, the rotation into the general practitioner's practice (GPP) as part of postgraduate medical training in general practice traditionally takes place at the end of the training period. The aim of this study was to explore possible subsequent effects of beginning training in the GPP from the perspective of general practitioners (GPs) and GP trainees.
METHODS
Nationwide, GPs and GP trainees were recruited who started specialization in GP in the GPP. Semi-structured telephone interviews were conducted between June and October 2022 using a self-developed interview-guide. The results were transcribed verbatim and analyzed using content analysis.
RESULTS
N=15 interviews were conducted, averaging 54 minutes (32-75 minutes) each (9 federal states, 4 GPs, 11 GP trainees). From the participants' perspective, advantages included close supervision, flat hierarchies, more time for preparation and follow-up, self-directed learning as well as higher basic salary and regular working hours. Positive effects mentioned were reinforcement in career choice, early understanding of workflow in GPP, early development of a GP attitude and strengthening of professional self-confidence. Disadvantages included initial uncertainty at the beginning of the profession and limited opportunities for peer exchange. In conclusion, all participants would recommend beginning specialization with a rotation in the GPP.
DISCUSSION
Starting in GGP allows GP trainees to learn about GP in a self-directed, research-oriented manner and based on consultations which enables early professional identity formation. GP trainees should avoid lack of collegial support by participating in a postgraduate training program. In a second step, GP trainers perspectives need to be assessed.
CONCLUSION
Beginning GP postgraduate training with a rotation in GP is advantageous and should be structurally promoted.
目的
在德国，作为全科医学毕业后培训的一部分，轮转至全科医生诊所（GPP）传统上是在培训期结束时进行。本研究的目的是从全科医生（GP）和全科医生培训学员的角度探讨在GPP开始培训可能产生的后续影响。
方法
在全国范围内招募了在GPP开始全科医生专业化培训的全科医生和全科医生培训学员。2022年6月至10月期间，使用自行编制的访谈指南进行了半结构化电话访谈。结果逐字转录并采用内容分析法进行分析。
结果
共进行了15次访谈，每次平均54分钟（32 - 75分钟）（9个联邦州，4名全科医生，11名全科医生培训学员）。从参与者的角度来看，优点包括密切监督、层级扁平、有更多时间进行准备和跟进、自主学习以及更高的基本工资和固定工作时间。提到的积极影响有强化职业选择、早期了解GPP的工作流程、早期培养全科医生态度以及增强职业自信心。缺点包括职业初期的不确定性以及同行交流机会有限。总之，所有参与者都推荐从在GPP轮转开始专业化培训。
讨论
从GGP开始培训使全科医生培训学员能够以自主、研究导向的方式，并基于会诊来学习全科医学，这有助于早期形成职业身份认同。全科医生培训学员应通过参加毕业后培训项目来避免缺乏同事支持的情况。第二步，需要评估全科医生培训师的观点。
结论
以在全科医生诊所轮转开始全科医学毕业后培训是有利的，应在结构上予以推广。
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