Investigation And Countermeasures Of The Training Quality Of Professional Degree Postgraduate In General Medicine

ObjectiveTo acquaintance the training quality of master degree in general medicine in China,analyze the factors affecting the training quality and put forward relevant suggestions,so as to provide reference for improving the training quality of master degree in general medicine in the future.MethodsAccess to relevant literature and documents understand the current situation of the cultivation of general medical graduates at home and abroad,and the factors affecting the quality of cultivation of graduates of general medical specialty in China were analyzed.Use self-made questionnaire surveys to investigate the 2017 graduates of general medical degrees in 12 universities in China.Based on the structure-process-results three-dimensional quality evaluation model,understand the cultivation quality of general degree graduates and analyze the impact factor on the quality of cultivation.Results1 According to domestic and foreign literatures,we know the foreign medical education system is different from China.They started the education of general medicine earlier.Therefore,the training mode of general practitioners is more mature.It is worthy of reference for us in terms of the rotation system and assessment standards.The education of master degree in general medicine in China started late,and now it adopts the mode of combination of standardized training and postgraduate education.In recent years,great progress has been made in enrollment,management and training.2 The questionnaire survey shows that 38 graduate students majoring in general medicine are all clinical medicine,of which the first volunteer to apply for general medicine accounts for 23.68%.Of the 12 colleges,there are 6 colleges with separate establishments of general medical schools.Thirty-eight postgraduates were trained in general practice in 16 training hospitals,and the average number of postgraduates in the training hospitals was three.The number of community bases for training hospital cooperation is an average of 3.Only one of the 16 training hospitals does not have an independent general medicine department.Postgraduate tutors are masters and doctors,accounting for 28.95%and 71.05%respectively.73.68%of the tutors were chief physicians.14 training hospitals are required to publish at least one academic journal paper,7 hospitals(43.75%)required journals at least at provincial level.The types can be reviews,treatises,and case reports.Two of these hospitals have no requirements for publishing papers.3 Process quality survey shows that the institutions adopt the instruction methods of lectures,online teaching,centralized teaching and so on,while the most common form of instruction is centralized teaching(86.84%).The most common form of communication is face-to-face communication.71.06%of the postgraduates'guidance mode is a single mentor system,and 81.58%of the mentors give less than 8 hours of guidance to graduate students per week.26(68.43%)graduate's projects came from self-selected topics under the guidance of mentors.The subject direction of clinical case analysis has 24(63.16%)postgraduates,while the subjects of health service management,general practice education and personnel training have 6(15.79%)and 5(13.16%),respectively.During the training process,21(55.26%)postgraduates manage 6-10 beds per week,and 24(63.16%)postgraduates believed that the teachers did not pay attention to the cultivation of general practice thinking in the clinical process.The actual training process of graduate students that match full with that of 2017 accounting for 13.16%,while the basic match accounting for 81.58%.27(71.05%)postgraduates' community practice time last for 6 months,in the community training process they regularly carry out publicity activities such as health education,and to guide family doctors the content of contract services.4 Result quality survey shows that 94.74%of postgraduates passed the qualification examination for practicing doctors,and 15.79%of postgraduates had the experience of failing the graduation examination.The types of journal papers published upon graduation were SCI,Chinese core journals,scientific and technological core journals and other statistical source journals,which were 3(7.32%),11(26.83%),7(17.07%)and 20(48.78%)respectively.71.05%of graduate students only published 1 paper.In the self-evaluation of the improvement degree of "medical record writing and medical history collection ability,diagnosis and treatment ability as well as operation ability,literature consulting and summary abilities,data analysis and paper writing ability,diagnosis and treatment as well as referral ability of common diseases in communities,health management as well as prevention and health care ability,professional ethics and humanistic quality",the proportion of"higher group" was 63.16%,50%,42.11%,42.11%,23.68%,55.26%and 52.63%,respectively.In comparative analysis on the improvement degree of "medical record writing and medical history collection ability,diagnosis and treatment ability as well as operation ability,literature consulting and summary abilities,data analysis and paper writing ability,diagnosis and treatment as well as referral ability of common diseases in communities,health management as well as prevention and health care ability,professional ethics and humanistic quality" between the "Double First-class Project" colleges and other colleges,there was no significant difference(P>0.05).ConclusionsAt present,China has formed a general practice degree postgraduate education system,and has made remarkable achievements in the number of enrollment and education operation.In terms of the education structure,training base development of general medicine discipline is in place,and maintains a good cooperative relationship with community base.Graduate students in colleges and universities have strict rules and regulations as well as graduation requirements,but some colleges and universities have not established general medicine departments.In terms of the education process,graduate students are arranged for training according to the general curriculum established by the state,while undertake studies of theoretical courses and scientific research,with corresponding plans and training objectives.Nevertheless,the guidance of the tutors to the students is generally inadequate,in the clinical transfer process of the graduates,the instruction is lacking in general awareness,and the teaching staff needs to be further improved.There is a lack of standards for the regular assessment of general practice competency in the course of education,and the problem of formalization is a serious.In terms of education results,graduate students of general practice are overall satisfied with the theoretical course sat,the pass rate of qualification examination of practicing physicians is high,and the candidates have sufficient scientific research abilities.In terms of self-evaluation,it is generally believed that the improvement of "the ability to consult and summarize literature,the ability to analyze data and write papers,the ability to diagnose and treat common diseases in communities,and the ability to refer patients" is insufficient.There is no significant difference between the "Double First-class Project" colleges and other colleges in the education of various abilities.Therefore,in order to improve the education quality of general practice professional degree postgraduates,the development and management of departments should be strengthened to ensure the structure and quality.To promote the training of general practitioners' instructors and teachers,and to strengthen the general practitioners' education team,it is also necessary to standardize the training process and improve the general practice quality and ability.