| ObjectiveTraining of general practitioners is an important way for construction of primaryhealth personnel, which has an important significance for improving the quality andlevel of primary health care services, so as the sustained and healthy development ofthe primary health services. In1997, The Chinese government has proposed thestrategy of speeding up the development of general medicine and training of generalpractitioners. Since then, the general practitioner education and training in China havedeveloped vigorously. However, the general practice education and training in Chinaare still belonging to exploration stage at present. There is less study on effectevaluation about the training of general practitioners. Some scholars have conducted aqualitative analysis about training effect of general practitioners, but they paid moreattention to training satisfaction. Most of the researches are evaluating afterwards, sothey are lack of some comparison between before and after training. There are somepurposes for this study as follow.1. Using the Kirkpatrick assessment model as the foundation to explore andestablish a training effect evaluation index system, meeting current needs, for generalpractitioners. After two rounds Delphi consultation by e-mail, we determined theevaluation index system to evaluate the training effect of backbone generalpractitioners, and calculate the weight of every index.2. Trying to find the deficiency of general practitioners training work, and putforward some countermeasures and suggestions, after using the evaluation indexsystem to evaluate the training effect of backbone general practitioners in Guangdong Province.Methods1. Construction of general practitioners training effect evaluation index system.Based on policy research and literature study, according to the Kirkpatrick assessmode, the co-ordination group developed an initial evaluation index system.2. Evaluation of the training effect for backbone general practitioners inGuangdong Province. A training effect assessment model of general practitioners wasestablished on the base of the Kirkpatrick assessment model. A total of176trainees inGuangdong were investigated before training, after training and after training for3~6months separately from reaction, learning, behavior and results. The specificassessment methods included a questionnaire, test paper,360degree assessment, andso on. At last fuzzy comprehensive evaluation were applied to assess the overalleffect.Results1. The index system was established after two turn’s consultation, whichconsisting of4first grade indexes,10second grade indexes,18third grade indexes and31forth grade indexes. The active coefficient of two rounds Delphi is84.00%and90.48%respectively;the authoritative coefficient of two rounds is0.85;the harmoniouscoefficient of the two rounds Delphi is0.314（χ2=39.027，P>0.05）and0.754（χ2=89.205，P<0.05）.2. The evaluation results of the training effect for backbone general practitionersin Guangdong Province.①I n the theory training of the reaction layer,students scoredhigher on the items of training teachers and process. The items that the trainees wereless satisfied with were training contents and facilities to guaranteeing the trainingprogram．In the practice training, the items that the trainees scored higher weretraining teachers and activities. The items that the trainees were less satisfied withwere training environment and guarantee.②In the theory training of learning layer,the average scores of the trainees before and after training were (44.64±7.45) and(62.52±9.72), and the difference was statistically significant (P<0.05). Theself-evaluation scores of the trainees on general medical knowledge and each systemdiseases clinic skills after training were significantly higher than those before training (P<0.05) except for the basic clinical skills. The items that the trainees were lesssatisfied with were training contents and facilities to guaranteeing the trainingprogram.③In the behavior layer, the behavior of trainees after training improvedgreatly. The rate of significant improvement of each indicator was more than70%.We did a sort according to the improving level of the behavior after training fromstudents’leaderships, colleagues and the trainees themselves evaluation, the sortresults were occupation ethics and team spirit, work process and developmentcapacity.④In the result layer, patient satisfaction, work performance and complaintshad greatly improved. Among them, the highest degree of improvement was patientsatisfaction. The improved rate of patient satisfaction from leaderships, colleaguesand the trainees themselves all achieved90%above.⑤The results of the fuzzycomprehensive evaluation. The comprehensive effect of backbone generalpractitioners training effect was good. The comprehensive evaluation results ofreaction and learning layer were good, and the behavior and result layer wereexcellent.Conclusions1. In the two rounds Delphi consultation, panel of experts show great initiativeand have great authority on research subjects. All experts have been tending toconsentience after two turn’s consultation, and the result is reliable. This index systemhas considerable reference value in the evaluation of training effect for generalpractitioners.2. According to the appraisal results of the training effect for backbone generalpractitioners in Guangdong Province, there is still much to be improved in trainingneeds assessment, training content design, the organization and management oftraining project, practical training environment and training effect evaluation. |
