摘要
背景随着居民疾病谱的改变和国家分级诊疗的推进,全科医生在疾病诊疗中扮演着重要角色。同时,医学知识的不断更新和居民卫生服务需求的持续变化,需要全科医生不断参与继续教育培训,给患者提供最佳的诊疗决策和疾病管理。目的分析近十年(2013—2022年)我国全科医学继续教育培训研究的发展现状、培训质量与研究质量。方法2023年1月,以PubMed、Cochrane Library、Embase、CINAHL、ERIC、中国知网、万方数据知识服务平台、中国生物医学文献服务系统8个中英文数据库为数据来源,获取有关中国全科医生继续教育的培训研究,进行阅读、分析、整理和总结,检索时限为2013年1月—2022年12月。利用医学教育研究质量量表(MERSQI)对文献的研究质量进行综合评价。结果本综述共纳入文献49篇,其中英文文献11篇,中文文献38篇。继续教育的培训主题集中于心脑血管疾病(22.4%)、急救相关内容(6.1%)、精神疾病(6.1%);培训形式较为单一,以传统的专家授课为主(69.3%),仅6.1%采用技能培训的形式,4.0%的研究采用PBL/TBL教学的培训形式;通常缺乏严格的评价:有31项(63.2%)研究采用问卷对培训效果进行评估,其中19项未经信效度检验。研究设计中,单组前后对照的研究设计占比最大(53.1%),随机对照前后测占比26.5%,对照前后测占比最小(4.1%)。明确提及进行伦理审批的研究有9项(18.3%),大多数研究未进行伦理审批(81.7%)。评估集中于针对全科医生培训前后的知识和技能提升(85.7%),较少涵盖实际行为改变(14.2%)及对于患者和医疗机构的获益(22.4%)。结论近10年全科继续教育研究的关注度不足,但发展空间较大。未来需要根据实际需求,拓展培训主题、采取多元的培训方式,利用信效度佳的评估工具,并关注培训后所带来的实际行为改变,以此让患者获益,多维度提升全科医生继续教育培训的质量。
Background With the changing disease spectrum of the population and the advancement of the national tiered diagnosis and treatment system,general practitioners play a vital role in disease diagnosis and treatment.At the same time,the continuous updating of medical knowledge and the ongoing changes in the health service demands of the residents necessitate the ongoing participation of general practitioners in continuing education and training.This ensures they can make the best diagnostic and treatment decisions and manage diseases effectively for their patients.Objective To analyze the current developments,training quality and research quality of continuing education research of general practice in China in the past ten years(2013-2022).Methods In January 2023,eight Chinese and English databases including PubMed,Cochrane Library,Embase,CINAHL,ERIC,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,and China Biology Medicine Literature Service System were used as data sources to obtain research on the training of continuing education for general practitioners in China.The literature was read,analyzed,organized,and summarized,with the search period ranging from January 2013 to December 2022.The Medical Education Research Study Quality Instrument(MERSQI)was utilized to comprehensively evaluate the quality of the literature.Results This review included a total of 49 articles,of which 11 were in English and 38 in Chinese.The themes of continuing education training focused on cardiovascular and cerebrovascular diseases(22.4%),emergency-related content(6.1%),and mental health(6.1%).The training formats were relatively singular,mainly based on traditional expert lectures(69.3%),with only 6.1%adopting the form of skill training,and 4.0%of the studies using problem-based learning(PBL)or team-based learning(TBL)training formats.There was usually a lack of rigorous evaluation:31 studies(63.2%)used questionnaires to assess the effectiveness of the training,of which 19 had not undergone valid
作者
侯姝羽
曾欣
王婷婷
牟彪
雷玉
吴富菊
罗晓红
邹川
HOU Shuyu;ZENG Xin;WANG Tingting;MOU Biao;LEI Yu;WU Fuju;LUO Xiaohong;ZOU Chuan(College of Medicine and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;Department of Family Medicine,the Fifth People's Hospital,Chengdu University of Traditional Chinese Medicine,Chengdu 611130,China)
出处
《中国全科医学》
CAS
北大核心
2024年第28期3476-3482,共7页
Chinese General Practice
基金
2020年成都中医药大学教改课题(JGJD202021)
2021年四川省医学会课题(Q20100)
2022年五医院教改课题(JGZX202215)
2020年五医院教改课题(JGJD202023)
成都中医药大学教育教学改革项目(2022CXMG01)。
关键词
教育
继续
全科医生
系统评价
质量
Education,continuing
General practitioners
Systematic review
Quality
