| ObjectiveBased on the background of the current increase of chronic disease patients,the urgent need to improve the ability of general practitioners to diagnose and treat chronic diseases,and the lack of evaluation of continuing education programs for general practitioners,this paper objectively evaluates the program of training sub specialized general practitioners in Chaoyang District through satisfaction evaluation,demand survey,training performance comparison,interview and recording analysis,so as to reflect the overall effect of the program and discuss the current situation In order to provide a model for other regions to improve the ability of general practitioners to diagnose and treat chronic diseases and to carry out the training of general practitioners with sub expertise.MethodsBased on the project of improving the ability of general practitioners in chronic disease diagnosis and treatment in Chaoyang District,this study investigated 39 general practitioners who completed the 10-month training of the project.The questionnaire survey was used to investigate the satisfaction and training needs of the project trainees after the response level training,the causes,diagnosis,treatment and case analysis knowledge of chronic diseases before and after the learning level training;the semi-structured interview was used to understand the main changes in the behavior of the project trainees after the training and the benefits brought to the organization at the result level;and the unified interview was used Based on the analysis of general practitioners' basic information,satisfaction,and the difference between before and after the training,the method of double-blind coding was used to analyze the interview recording results,further enrich and improve the project effect evaluation,and explore the effect and existing problems of the project.ResultGeneral situation:the age of general practitioners who have completed the project training is mainly between 30-40 years old.The proportion of general practitioners who have bachelor's degree is 73.95%.57.98%of the general practitioners who have participated in the training have junior professional titles,67.32%of them are from general practitioners,and the average working age is(11.41±6.21)years.Response layer evaluation:mainly carry out satisfaction evaluation,participate in project influencing factors and training demand survey.? General practitioners were satisfied with the overall evaluation of the project(4.67 ± 0.52),and doctors with different education background,professional title and different ways of training had no significant difference in the overall evaluation of the project.Among them,the average score of practical training satisfaction is(4.68±0.35),which is higher than the average score of theoretical training satisfaction(4.55±0.50).?The top three factors influencing the participation of general practitioners in the training were the contradiction of engineering and learning,inadequate training guarantee and unclear training objectives,which were 22(56.41%),7(17.95%)and 7(17.95%).? The top three training needs of general practitioners are diagnosis and treatment of common diseases and frequently occurring diseases(37 people,94.87%),basic clinical skills(29,74.36%)and emergency diagnosis and treatment(26 people,66.67%).In addition,the trainees also have great demand for community prevention and health care,rehabilitation knowledge and rehabilitation physical therapy technology.Evaluation of learning level:it mainly compares the average and difference of the overall performance of the trainees before and after the training,and the average and difference of the classification performance.?The average score after training was(74.71±10.90).higher than the average score before training(71.47±11.77),P=0.0001,with statistical significance.? According to the knowledge points,the test items are divided into four categories:etiology investigation,diagnosis,treatment and case analysis.Among them,the scores of some and only diagnostic items before and after the training are statistically significant.The mean score of diagnosis score after training(74.35±11.79)was higher than that after training(65.58 ±15.96),P=0.0000,the difference was statistically significant.After training,the scores of etiology investigation decreased a little,the mean difference was(-6.03±29.98),there was no significant difference.The mean difference of treatment scores was(5.95±19.72),and the mean difference of case analysis scores was(6.38±35.23).The scores improved after training,but the difference was not statistically significant.Behavior level evaluation:it mainly deals with the recording and coding of students'interviews.Students' professional ability has been improved,including the update of frontier knowledge theory,diagnostic standards and basis,the improvement of clinical performance cognition,the expansion of differential diagnosis thinking,and the standardization of diagnosis and treatment behavior;students' self-awareness has changed,good learning habits have been formed,self-confidence has been improved,and doctor-patient communication and humanistic care have been strengthened.Result level evaluation:mainly for the recording and coding of students' interviews.The organization of the trainees has gained certain benefits,including the formation of self-learning atmosphere in the community,smooth two-way referral channels,and projects promoting the cooperation and development of community scientific research.ConclusionsThis study shows that the general practitioner's slow disease diagnosis and treatment ability improvement project has achieved certain results,and the project satisfaction is high.The general practitioner's clinical thinking ability,slow disease diagnosis and treatment ability,difficult and critical disease identification and two-way referral ability have been improved to achieve the expected training effect,but the training content setting,training program formulation,assessment and incentive mode still need to be improved.Suggestions for this:the government should give full play to the leading role,unite the community and the third level general hospital to plan the resources of continuing education reasonably,and realize the high level and homogeneity of continuing education for general practitioners;before and after the opening of the project,the training contents of the project should be set up according to the training needs,and the training quality should be ensured by adjusting the theoretical study,rotation arrangement and workload;the relevant projects should be The supporting assessment and feedback mechanism,the combination of theory and practice,make the assessment as objective and comprehensive as possible;relevant projects should actively explore the incentive mechanism to stabilize the general practitioner team,stimulate the self-study of general practitioners;should actively explore the training mechanism of general practitioners with subspecialty related to chronic diseases under the medical association model,improve the continuing education system of general practitioners,and make the two-way connection closer and practical At present,the Regional Medical Association closely cooperates in talent sharing,technical support,inspection and mutual recognition,and settlement of diagnosis and treatment scheme with two-way referral as the link,actively guides residents to go to the grass-roots level for first diagnosis and promotes the implementation of hierarchical diagnosis and treatment system. |
PDF Full Text Request