摘要
目的 了解北京市乡村两级即乡镇卫生院医务人员和乡村医生继续医学教育现状和政策工具对其具体影响.方法 2016年7月至8月,课题组根据地理位置、经济水平、历史文化等因素选取北京市H区C乡、J镇和B镇所辖乡镇卫生院及下辖21个行政村作为调查现场进行实地观察和个人深入访谈,采取质性研究中的目的性抽样方法,抽取21名乡镇卫生院医务人员、21名乡村医生、42名村民共计84人进行深入访谈.访谈内容包括个人基本信息,基本医疗服务提供,继续医学教育方式、学时、内容和效果等.结果 H区乡镇医务人员接受继续医学教育动力较足,“多形式、多渠道”培训形式得到医务人员基本肯定,培训内容得到认同,培训效果较好.在村一级,乡村医生接受继续医学教育动力较弱,“以会代训”和“网络化教学”的并轨使继续教育不同程度“走过场”,培训内容与实际需求存在差距,培训效果一般.结论 直接性政策工具的规制方式和直接提供方式因为缺乏灵活性和竞争机制使乡村两级继续医学教育的作用不能充分发挥,需要以疾病谱变化为依据,增加“因地制宜、有的放矢”的培训内容,在强化考核的同时改进激励机制,调动医务人员的学习自主性与积极性.
Objective It is important to understand the status quo of continuing medical education in Beijing rural area and specific influences of policy instruments on it.Methods According to the geographical position,economic level,historical and cultural factors,from July to August,2016,the investigation group selected the J,C and B township of H county in Beijing as well as its 21 administrative villages as research field to conduct field observation and individual in-depth interviews.The sample included 21 township hospital doctors,21 village doctors,42 villagers as total of 84 people.Interview questions include：personal basic information,basic medical and public services,continuing medical education method,class hours,content,and effect.Results The status quo of continuing medical education in H County presented the following condition：township medical staffs were willing to accept continuing medical education,diverse forms and lessons＇ contents were affirmed,the effect was overall better.At village level,village doctors accepting continuing medical education power was weak,education form combined with network teaching system conducted ineffectively,there was a gap between training content and actual demand,the effect was overall general.Conclusions Regulation and directly provision of direct policy tools had some drawbacks in terms of lack of flexibility and competition mechanism gave rise to negative action of continuing medical education.It was necessary to adjust contents and improve incentive mechanism for enhancing learning autonomy of township doctors.
出处
《中华医学教育杂志》
2018年第1期113-118,共6页
Chinese Journal of Medical Education
基金
首都卫生管理与政策研究基地重大项目（2016JD01）
首都卫生管理与政策研究基地重点项目（2016JD02）
关键词
政策工具
继续医学教育
乡村两级
影响闲素
Policy instruments, Continuing education, Township and village
Influencing factor
