Study On The Current Situation And Countermeasures Of Standardized Training For Rural Order-oriented Medical Students Under The "5+3" Model In Chongqing

Objective:Free medical education for rural order orientation is a national strategic education program for the purpose of training primary general medicine talents.At present,the training of general practitioners in China mainly adopts the "5+3" model,that is 5 years of undergraduate clinical medical education + 3 years of standardized training(hereinafter referred to as "training").The aim of this study is to investigate the training situation of rural students under the "5+3" model,analyse the main problems and causes of the training process,and explore suggestions and countermeasures to improve the quality of training.Methods:The questionnaire survey was conducted with rural order-oriented medical students who completed their training at Chongqing residency training bases in 2018 and 2019 respectively and returned to Chongqing to perform in various orientation employment units.Interviews were conducted with general practice teaching teachers,general practice training trainees and general practice training base managers.The results of the questionnaire survey were subjected to descriptive statistics,t-test and rank sum test using SPSS25.0 software,and differences were considered statistically significant at P < 0.05.Results:1.During the training period,61.95% of the trainees considered the reasonableness of the actual rotation situation as "fair","very unreasonable" and "not very reasonable".49.72% of the trainees were trained in clinical skills centers for "less than 7 times";the rotation pattern of the primary practice base was mainly "6 months at a time";the least frequent teaching activity during the training period was case discussion.15.28% of the trainees considered that they were "very unsatisfied" or "relatively unsatisfied" with the number of basic public health service skills and cases learned during their training in primary practice.2.Satisfaction with general practice training: the overall satisfaction score was(3.63±0.62);the lowest satisfaction during clinical training was "the reasonableness of rotation departments and time"(3.03±0.93);the lowest satisfaction during primary practice training was "the ability of teaching teachers to teach "(3.52 ± 0.84),and the lowest satisfaction score of independent learning ability was(3.35±0.92);there was a difference in the overall satisfaction evaluation of the regulation training among rural order-oriented medical students with different numbers of training in clinical skill centers(P<0.05).3.Self-evaluation of knowledge and skills in general medicine: the self-rating of overall competence was(3.46±0.79);the lowest score in knowledge of general medical services was scientific management of community resources using management theory(3.30±0.93);the lowest score in skills in general medical services was family doctor’s home visit service(3.38±0.90);the lowest score in skills in basic public health services was management of patients with severe mental disorders(3.09±0.94).The lowest score among the skills of basic public health services was the management of patients with severe mental disorders(3.09±0.94);There were differences in the self-evaluation scores of knowledge and skills of general medicine among rural order-oriented medical students with different numbers of training in clinical skills centers and rotation patterns in primary practice bases(P <0.05).4.Work adaptation status: 42.78% of the trainees reflected that the knowledge and skills acquired during the training process matched the actual work needs by more than 60%;68.06% and 61.11% of the trainees thought that they lacked the ability to socialize and adapt as well as the ability to learn and innovate.Conclusion: At present,the following problems exist in the process of regulation training of rural order-oriented medical students: the construction of general medicine departments needs to be strengthened;the clinical rotation scheme needs to be optimized;The quality of grassroots practice training needs to be improved;clinical skills training needs to be strengthened;Training process management is not strict enough;and the comprehensive quality of rural order-oriented medical students needs to be enhanced.In view of the above problems,the following countermeasures are proposed: strengthen the construction of the department of general medicine,optimize the rotation scheme of clinical departments;strengthen the management and supervision of clinical training bases and standardize the grassroots practice training;strengthen the construction of general medicine teachers and improve their teaching level;standardize the training process and strengthen the process management;enhance the comprehensive ability of rural order-oriented medical students.