Abstract
BackgroundThe Chinese government offered various types of training programs for strengthening the role of doctors working in community health service institutions (CHSIs). The study intended to investigate the current training programs and training needs of doctors nationally in urban CHSIs in China, and to provide propositions for training more qualified doctors in the future.MethodsTotal 3098 doctors in 192 urban CHSIs were chosen from 9 provinces (Hebei, Liaoning, Shandong, Zhejiang, Fujian, Hunan, Guangxi, Guizhou, Ningxia) and one municipality (Beijing) among 31 provinces in eastern, central, and western regions by stratified sampling methods in Mainland China. All doctors in the selected CHSIs were investigated in this study. We discharged 3073 questionnaires, and the response rate was 98.0%. Descriptive statistics were used to describe the characteristics, training contents, problems and needs of doctors. Differences in training contents, problems and needs between eastern, central and western regions were analyzed with chi-square tests.Results49.3% of doctors in CHSIs had Bachelor’s degree and beyond. 12.9% of doctors had senior professional titles. The most frequent training topics for the doctors in eastern, central and western regions were “basic clinical theory knowledge” (52.4%), “community health service competency” (59.6%), “clinical practice skills” (45.9%) respectively. The most serious problem for doctors was “insufficient training time” in eastern (36.8%), central (36.5%) and western (39.6%). The biggest knowledge need for doctors both in eastern (79.8%) and central region (79.1%) was “the updated international medical knowledge”, in western region it was “the updated domestic medical knowledge” (73.2%). The biggest skill-related training need for doctors in eastern region (84.1%) and central region (82.6%) was “communication skills”, and “diagnosis and differential diagnosis” in western region (78.2%).ConclusionGovernment should design proper training contents according to the knowledge and skill needs of different design. Furthermore, a uniform, rigorous training and evaluation system focus on practicability should be established to promote community health service system in Mainland China.
Highlights
The Chinese government offered various types of training programs for strengthening the role of doctors working in community health service institutions (CHSIs)
As continuing medical education (CME) programs, the train-the-trainer program, which emphasizes the training of qualified trainers, and the training programs hold by CHSIs, were considered supplements to teaching and training programs
Sampling methods and participants The general stratified sampling method was adopted to select 9 provinces and one municipality from the available 31 provinces which divided into three regions in Mainland China; the provincial capital cities and two other random cities were selected from each province; 3 city districts based on good, moderate and poor economic condition were selected from each city; 3 CHSIs were selected according to the CHSIs’ development status
Summary
The Chinese government offered various types of training programs for strengthening the role of doctors working in community health service institutions (CHSIs). Since 2000, the Chinese government offered various types of training programs for strengthening the role of all CHSIs providers, for doctors (including GPs and physicians of other medical specialty who will be trained to be qualified GPs). On-the-job training program and transfer-job training program which offer a transitional solution for the shortage of GPs have a 1-year (full-time) training duration and target at retraining less trained CHSIs doctors who received 3 to 5 years of medical education after high school or other medical specialties to become a qualified GP. The postgraduate residency training program which lasts for 33 months (full-time) is mainly for graduates with 5 to 8 years post-high school medical education background, and includes two stages: (1) Hospital-based Clinical rotation and (2) CHSIs-based training [10]. It is necessary to investigate the current training and future training needs of GPs nationally in china, no such study has been carried out to date
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