Research On The Satisfaction Of Standardized Training Of General Resident Physicians In Chongqing And Its Optimization Strategy

Objective: To comprehensively promote and improve the standardized training of general residents(hereinafter referred to general resident training)is an important measure to deepen the reform of medical and health system and medical education in China,and the general resident standardized training is one of the important ways to cultivate the qualified general residents.Chongqing,as the first province to start the resident standardized training and the general practitioner cultivation,has been relatively perfect in the construction of the general resident training system,policy support,security measures and other aspects,but there are still deficiencies,and there is still a space for further improvement.The purpose of this study is to understand the satisfaction of the trainees during the training from the perspective of their feelings,further explore the feasible direction of optimization in the process of general resident training,and provide the feasibility basis for the policy-making of the municipal health administrative department from the perspective of the trainees' participation experience.Methods: The literatures of general resident training were searched by literature reading,the current situation of general practitioner training in Chongqing was understood by literature sorting,the experience satisfactionof general resident trainees was deeply explored from the perspective of the innovation in the participation experience of these trainees,the influencing factors of trainee satisfaction were analyzed,and the optimization way was figured out under the guidance of these influencing factors.In the study,the number of questionnaires was obtained by calculating the sample size,and then the students from 10 general resident training bases in Chongqing were investigated by using the questionnaires;400 questionnaires were distributed,and 380 valid questionnaires were recovered.Through questionnaire survey,the information of general resident trainees was obtained,and the satisfaction survey was completed with the cooperation of trainees.After inputting,sorting out and making statistics of the data,we discussed the satisfaction of general resident trainees and its influencing factors through the single-factor / multi-factor Logistic regression analysis,which lays the foundation for putting forward to the effective optimization strategies.Results:(1)According to the baseline data,there were significant differences in the gender,age,education background,marital status,personal nature,training time,medical practitioner license,and monthly average income of general resident trainees(P < 0.05)and no significant difference in other aspects(P > 0.05).(2)The satisfaction evaluation items of general resident trainingmainly included the national resident training policies,training plan,theoretical training,base rotation,community rotation,and graduation assessment,teaching level,and income satisfaction.The survey results showed that the general resident trainees had the lowest satisfaction to the base rotation,followed by the community satisfaction and then the graduation assessment(the highest satisfaction).The satisfaction to the national resident policies was 88.95%(338/380),and there was a significant difference between the percentages of trainees with satisfaction and dissatisfaction(P < 0.05).(3)The following factors were correlated with the satisfaction of general resident trainees: age,education background,personal nature,training time,medical practitioner license,monthly average income,one-to-one teaching,teacher training,and professional title of teachers(P <0.05).(4)The results of multivariate logistic regression analysis showed that within 95% confidence interval(CI),OR>1 indicated that the risk factors for the satisfaction of general resident trainees were <5,000 monthly income and 2-year training(P < 0.05),and OR<1 indicated that one-to-one teaching and teacher training were the protective factors for the satisfaction of general resident trainees(P < 0.05).Conclusion: Through the analysis on the participation experience inthe general resident standardized training,the trainees had low satisfaction to the training plan and community rotation;as shown by the analysis on the influencing factors of train satisfaction,the main factors for the dissatisfaction of general resident trainees were <5,000 monthly income and 2-year training,which will affect the recognition of trainees to the resident standardized training and thus usually result in low satisfaction.One-to-one teaching and teacher training were the protective factors of trainee satisfaction.Based on these factors,we can further optimize the general resident standardized training by the following ways: 1)deeply propagating and interpreting the latest policies of general resident training and strengthening the comprehension and application abilities of trainees;2)enhancing the linkage between the general medicine professional bases and improving the homogeneous cultivation quality of trainees;3)focusing on the ideological guidance and penetrating the medical humanity education into various training links;4)paying importance to the training experience of trainees,strengthening multi-party communication and exchange and keeping perfecting the training workflow;5)promoting the construction of the teacher team by assessment,optimizing the teacher assessment system,and continuously improving the specialization of teachers;6)decreasing the economic pressure of trainees and promoting the training concentration and input of trainees.