| Objective:The purpose of this study is to understand the present situation and existing problems of the training of rural demand-oriented medical students through the empirical study of 3 higher vocational colleges in Yunnan province.based on the analysis and generalization of the basic situation,curriculum,teacher strength and its influencing factors.Based on the demand of assistant general practitioner training in Yunnan province and the needs of rural medical and health work,this paper explores reasonable improvement methods and implementation approaches,probes into the training mode of Yunnan Provincial order-oriented medical college students,and provides some countermeasures and suggestions for promoting the training of order-oriented medical college students.Methods:Qujing Medical College,Chuxiong Medical College and Honghe Health Vocational College selected as survey sites.Three school's training program,syllabus,internship program,and other training materials were collected.A purposive sampling and stratified cluster sampling were employed,involving 114 teachers and 413 students for the surveys,7 managers,24 teachers and 60 undergraduates were selected for personal in-depth interview or group interview.The content of the questionnaire includes the basic information,evaluation and satisfaction of the training goal,course setting,teaching content,teaching method,examination form and teaching effect,including the relevant training policy,training mode,teaching arrangement,teaching management,comments and suggestions on curriculum design.The collected data and interview results were summed up,and the data of questionnaire survey was input by using Epidata3.1,and statistical analysis was carried out by using SPSS 17.0 Statistic software package for Chi-square test,rank sum test,multiple response,binary logistic regression.Results:1.In the course of the implementation of the free training program for the demand-oriented medical students in Yunnan Province,all the training institutions have formulated the training goal,the course teaching program and the practical teaching plan for the students.However it was basicly consistent with the general clinical specialty,without the differentiation training.2.In terms of education policy awareness,teachers who were well know of the training policy well accounted for 5.41%,students who were well know of the training policy well accounted for 1.48%,teachers and students who were aware of the training policy well accounted for 49.55%.and 67.98%.3.In the awareness of training objectives,teachers and rural demand-oriented medical students all thought that the training objectives should include:a strong sense of serving the grassroots people's health,solid knowledge of basic medical theory and skills,primary ability to diagnose and public health services.61.26%of teachers and 62.06%of the rural demand-oriented medical students known the training goals of the school,while 89.7%of the teachers and 94.84%of the rural demand-oriented medical students thought the current training objectives were reasonable.4.For the choice of training mode,33.33%of the teachers and 37.19%of the rural demand-oriented medical students thought the most suitable way was "2 years of theoretical study + 0.5 years of General Hospital Internship + 0.5 years of primary medical and health center internship."5.In terms of curriculum,6.31%of the teachers thought that the courses offered met the students' learning needs,and 3.20%of the rural demand-oriented medical students believed that the current textbooks were good enough to meet their own learning needs,19.82%of the teachers and 4.93%of the rural demand-oriented medical students believed that the current curriculum was very helpful to engage in primary health care.90.99%of the teachers and 87.44%of the rural demand-oriented medical students thought that the assistant general practitioner qualification examination served as the guide to set the curriculum module,90.99%of the teachers and 92.86 of the rural demand-oriented medical students thought it was necessary to take the assistant general practitioner training as the guide to set the curriculum module.With regard to the setting of compulsory courses and elective courses,14.04%and 6.4%of the students were very satisfied with the course arrangement and elective course content of the compulsory curriculum and 43.84%of the students thought that the ratio of compulsory courses to electives should be 3:1,and the compulsory course modules could include public courses,professional basic courses,professional courses,Public health courses,and professional probation.Teachers and rural demand-oriented medical students all thought it was necessary to set up ethnic custom and culture courses,common infectious diseases,family planning technology,ethnic medicine,Traditional Chinese medicine and other elective courses.6.With regard to the choice of teaching methods,10.1%of the rural demand-oriented medical students were very satisfied with the current educational methods,and both teachers and pupils thought that case teaching,teaching style and problem-oriented instruction could be applied.7.For the course examination form,8.13%of the rural demand-oriented medical students were very satisfied with the existing assessment form,while 49.55%teachers and 49.75%of the rural demand-oriented medical students believed that written test + skill operation + oral examination could be carried out for the examination.8.In terms of practice-based teaching,48.65%of the teachers and 43.6%of the rural demand-oriented medical students thought that it was good for students in their grade 3 to practice in a community health center.36.21%of the rural demand-oriented medical students believed that the general Hospital and basic hospital internship time ratio should be 3:1.13.76%of the rural demand-oriented medical students were very satisfied with the training of clinical practice skills,while 15.52%and 6.9%of the rural demand-oriented medicine students were happy about the General Hospital and the basic hospital internship.Rural demand-oriented Medical students thought that in the course of practice,we should mainly introduce solid medical theories and clinical skills,how to provide basic public health service,interpersonal communication and teamwork,and that key department for internship should emergency department and Internal Medicine department.89.66%of the students did not work or practice in a hospital they signed for.9.65.77%of teachers and 42.61%of rural demand-oriented medical students believed that learning has reached the learning objectives,10.34%of the students said that the teaching management was very satisfying.10.For the evaluation of the training mode,rural demand-oriented medical students who knew more about the training goal,who thought examinations reasonable and who reached their learning objectives,spoke highly evaluation of the training mode.The higher grade the students were worse.11.Yunnan Province rural demand-oriented medical students,managers,teachers,all shared their understanding of the theoretical curriculum,practical teaching arrangements,etc.They all claimed that,the present theory curriculum lacks the specialized characteristics,the curriculum should be revised and simplified,traditional ethnic medicines should be introduced,the Chinese Medicine diagnosis and treatment technology should also be available.Practice-based teaching should follow the principle of "early and more practices",and increase time for practice.12.The training mode of rural demand-oriented medical students in Yunnan province was preliminarily constructed based on the investigation results of the training status of the students in rural demand-oriented Medical College literature review and recommendations by experts.Conclusions:1.Rural demand-oriented medical students lacked targeted training sessions;2.The training policy for rural demand-oriented medicine was not known well among the students and teachers;3.The curriculum for rural demand-oriented medical students was not standardized;4.The teaching method for the rural demand-oriented medical students was not applicable;5.The examination form of the medical college for rural demand-oriented medical students was not used in a single manner;6.The practice based teaching system for rural demand-oriented medical students was incomplete*Suggestions:1.Establish and improve the training program for rural demand-oriented medical students.2.Increase the level of rural demand-oriented medical students related training policy publicity;3.Optimize the course for rural demand-oriented medical students;4.Strengthen capacity building for the teaching staff in rural demand-oriented medicine students;5.Advocate a variety of teaching methods to improve the quality of education;6.Develop different examination forms;7.Develop and improve the practice based teaching system. |
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