Qualitative Study On The Factors Influencing The Practice Intention Of The Trainees In Standardized Training Of General Practitioners In Shandong Province

BackgroundGeneral practitioners are highly integrated,specially trained in general practice and working at the grass-roots level.They are able to provide individuals,families and community members with high-quality,convenient,effective and integrated medical care services,as well as whole-process and all-round responsible management of health and disease.Accelerating the training of a large number of qualified general practitioners is of great significance for strengthening the construction of the basic medical and health service system,establishing a hierarchical medical system,and maintaining and improving people's health.In recent years,the state attaches great importance to the training of general practitioners and reserves,and the standardization training general practitioners and institutionalization,but general practitioner training in our country still faces many problems,general practitioners position less attractive at the grass-roots level and after training of general practitioners practice rate is not high at the grass-roots level directly affects the general practitioners team construction.ObjectivesThe main purpose of this study is to investigate the general practitioners undergoing standardized training in shandong province,to understand their willingness and considerations to continue to engage in general practice,to analyze the existing problems,and to explore solutions to the existing problems,so as to provide a basis for retaining general practitioners and stabilizing the team of general practitionersMethodsThis study adopted qualitative research,and applied targeted sampling method.The researchers conducted in-depth interviews with 21 trainees who were taking standardized training courses for general practitioners at two training bases in jinan and Qingdao,shandong province,from June to August 2019.ResultsIn this study,a total of 21 general training trainees were interviewed,and five factors affecting the practice intentionthe of general training trainees were summarized as follows(1)Career factors.General practitioners have low social recognition and low social status;as a general practitioner in the grassroots can only see some common diseases,frequently-occurring diseases,there is no opportunity for training and promotion,and work development space is not big;general practitioners have too many responsibilities and too much pressure,and their main work in the future will be "less clinical and more public health".The above are the career factors of general training trainees' reluctance to become general practitioners.(2)Professional cognitive factors.Most of the interviewed general training trainees are in a passive state of understanding and concern about general practice,and have a poor understanding of general practice.general training trainees believe that general practitioners are not as competent as specialists,can do little for patients and lack professional identity.The above are the professional cognitive factors of general training trainees' reluctance to become general practitioners(3)Factors in standardized training.During the standardized training,the outpatient rotation time is less,and the training effect is not ideal.Teachers are basically specialist doctors,lack of general practice and teaching experience,can not give comprehensive guidance to the general trainees.The above are the factors in standardized training of general training trainees' reluctance to become general practitioners.(4)Policy factor.The primary diagnosis system at the grass-roots level is not perfect,and there are few drugs covered at the grass-roots level of the national basic drug system;the policies on developing and training general practitioners have not been put in place.The above are the policy factors of general training trainees' reluctance to become general practitioners.(5)Patient factors.Residents lack confidence in the ability of general practitioners to solve health problems and are reluctant to seek treatment in primary medical institutions.The above are the patient factors of general training trainees' reluctance to become general practitionersConclusions and RecommendationsThis study found that the factors affecting the practice intention of general practitioners include five aspects:career,professional cognition,standardized training,policy and patients.Recommendations:(1)Provide good training and career development opportunities to improve growth satisfaction;(2)Strengthen the publicity of general practice medicine,and improve the social recognition of general practitioners;(3)Increase government investment and establish reasonable compensation and incentive mechanism;(4)Define the positioning of general practitioners,and improve the general practice service team building;(5)Improve the hierarchical medical system and the system of basic drugs,and give full play to the role of health gatekeepers;(6)Improve teacher training and evaluation standards,and implement clinical and community-based education;(7)Change the mode of medical education and attract general medical talents.