Investigation Of The Curr Ent Standardized Training For Residents In General Practice In Shandong Province

Backgrounds&objectives:General medicine(GM)or family medicine(FM)is a key specialty in primary healthcare worldwide.Modern general medicine education curricula have changed.General physicians(GP)or family physicians(FP)have more comprehensive training in patients,medicine,and social issues than in the past.General physicians need to adapt to changing circumstances,but he needs to practice comprehensive and holistic medicine,as most of the time,General physicians are the first point of contact both in urban and rural setup.Standardized residency training(SRT)is a key stage of clinical skill training before general residents move to work.The effect of standardized training determines the improvement of clinical skills and competence of general physicians.Therefore,it is necessary to conduct a comprehensive investigation,analysis,and research on the current status of general practice resident training,with a view to providing practical reference for residents who participate in the general practice standardized training,teachers who participate in the standardized training of residents,hospital management personnel,and relevant government functional departments.Methods:Literature research,interview,questionnaire survey methods were used to develop a questionnaire for standardized training for residents in general medicine,and a questionnaire survey was carried out for students from 2014 to 2021 who participated in the standardized training of residents in general medicine in Shandong Province.Based on the results from the survey,an analysis was conducted on the overall satisfaction of the residents,the influencing factors for choosing the training hospital,the faculty strength of the hospital,the improvement of the theoretical level after the training,the improvement of clinical practical skills,the improvement of competence,the change of general practice recognition ability,and the job intention of the residents after the training,with the aim of providing a research data-oriented landscape of the current situation of standardized training for general practice medicine.Results:(1)The overall satisfaction of the residents with the standardized training in general medicine was good.(2)Improving personal ability is the main reason for residents who want to participate standardized training.The qualification of the clinical teachers in the training hospital was the primary influencing factor of the training site selection for the residents.The passing rate of the first licensed medical qualification examination(LPQE)for residents was 59.6%,which was not the higher expected passing rate,indicating that the basic medical knowledge of the residents was insufficient.(3)The satisfaction of salaries in postgraduate students who integrate professional and master programs was the lowest.The educational background,resident training status,and physician title at the time of enrollment had a significant impact on the satisfaction of resident training project(P<0.05).(4)The teachers in the community practice training sites are weak.The benefit and popularity of the case teaching method are the highest.The identity of the training residents at the time of enrollment training has an impact on the satisfaction of the teachers(P<0.05).(5)The medical theoretical level,clinical practice skills,competence,and the recognition ability of general medicine were remarkable.Gender,residence training status,current professional title and training stage had a significant influence on the improvement of theoretical knowledge and clinical practice ability.Gender and current professional title were the significant influence factors on the elevation of competence(P<0.05).(5)The intention of work site selection for the trained residents was mainly in secondary and tertiary public hospitals.The proportion who selected the primary health medical training sites was only 27.1%.For those who have completed the training,a survey of 181 residents showed that who worked in primary medical and health sites was 50.3%.None-general medicine residents who worked in general public hospital were 33.7%,which was much higher than that 8.30%for general medicine residents.The loss of general medicine residents is serious.(7)There is an obvious positive correlation between the response layer,the learning layer,and behavior layer.Rotation plan satisfaction and teacher satisfaction had a significant influence on medical theoretical level and clinical practice ability.Rotation plan satisfaction training content satisfaction and teacher satisfaction had a significant influence on competence improvement.Conclusion:(1)The residents were satisfied with the overall quality construction of standardized training for general medicine in Shandong Province.(2)There are significant learning effects in the residents during the training period.The improvement of the theoretical medical knowledge,elevation of clinical practice ability,competence in general medicine position,the recognition ability of general medicine was remarkable.(3)There are problems such as low salaries and benefits for postgraduate students who integrate professional and master programs,weak teachers in community practice training sites,and the loss of residents in general practice.These problems should be pay attention to by the training departments and managers at all levels.The competency-oriented general medicine standardized training for residents should be strengthened.The quality of standardized training for residents should be improved.(4)According to the development trend of modern medicine and the problems found in this survey,in order adapt to the constantly changing progress of medical research,changing healthcare conditions,and changes in medical systems,general practice education can focus more on person-centered care and healthcare systems as system-specific specialists,respect the differences in healthcare provision between urban and rural areas,and motivate medical students and residents to become family physicians.