Carlsson B, Gravgaard A M, Möller T, Wallin K, Lindholm L H
Department of Community Health Sciences, Lund University, Sweden.
J Cancer Educ. 1998 Spring;13(1):14-9. doi: 10.1080/08858199809528505.
To improve general practice (GP) trainees' knowledge of and attitudes towards oncology and their management of cancer patients.
A prospective study of 33 GP trainees who, after a first assessment, were randomized either to attend a two-year cancer course (n = 17) or to a control group (n = 16). Both groups were tested at the beginning (pretest) and end (post-test) of the two years. The maximum possible score was 76. All tests were corrected blindly by an oncologist and a general practitioner.
The intervention group showed significant post-test-pretest improvements in the domains "knowledge" (mean difference 2.6, 95% CI 1.3-3.8) and "attitudes" (mean difference 2.9, 95% CI 0.8-5.0), but not in "patient management" (mean difference 0.3, 95% CI -0.6-1.2). There was no significant change in the test scores of the controls. The total mean (post-test-pretest) differences were 8.3 (95% CI 4.9-11.6 for the intervention group and -1.4 (95% CI -4.1-1.3) for the controls.
A low-intensity two-year cancer course improved the knowledge and attitudes of GP trainees. Patient management, however, was not improved and may be more suited for hospital training. The current five-year specific training in general practice in Sweden seemed to be of limited value in the field of oncology. Thus, there is a need for further development of educational tools for cancer training of GP trainees, at least in Sweden.
提高全科医生（GP）培训学员对肿瘤学的知识和态度，以及他们对癌症患者的管理能力。
对33名GP培训学员进行前瞻性研究，在首次评估后，将他们随机分为两组，一组参加为期两年的癌症课程（n = 17），另一组为对照组（n = 16）。两组在两年开始时（预测试）和结束时（后测试）都进行了测试。最高可能得分是76分。所有测试均由一名肿瘤学家和一名全科医生进行盲法评分。
干预组在“知识”（平均差异2.6，95%可信区间1.3 - 3.8）和“态度”（平均差异2.9，95%可信区间0.8 - 5.0）方面，后测试较预测试有显著改善，但在“患者管理”方面没有改善（平均差异0.3，95%可信区间 - 0.6 - 1.2）。对照组的测试分数没有显著变化。两组的总平均（后测试 - 预测试）差异分别为：干预组8.3（95%可信区间4.9 - 11.6），对照组 - 1.4（95%可信区间 - 4.1 - 1.3）。
为期两年的低强度癌症课程提高了GP培训学员的知识和态度。然而，患者管理能力并未得到改善，可能更适合在医院进行培训。瑞典目前为期五年的全科医生特定培训在肿瘤学领域似乎价值有限。因此，至少在瑞典，需要进一步开发针对GP培训学员癌症培训的教育工具。
