| BackgroundGeneral practice has been developed for more than 20 years and has played an important role in promoting the health of the whole people,promoting the community medical service and saving the cost of medical treatment in China.It is an important factor of the development of community health service in our country,and that the establishment of the medical base is an important guarantee for the training of general practitioner.Presently,general medical education in China including college education,resident standardized training,continuing education.There are two important ways to train general practice.One is general practitioner resident standardized training,the other is professional degree graduate.General practice teacher includes general practice theory teacher,general practice clinical teacher,general practice community teacher.Different stage general practice teacher have different teaching characteristics,these general practice teachers not only have to be very clear and understand the teaching contents and methods of this stage,but also proficient in other stages of the education purpose and task.Only in this way we can make the mode of training general practice teacher to be systematic.Although the training of general practitioner in our country is developing rapidly,it is still in the initial stage.Objective1 To understand the current situation of general practice domestic and international2 To understand the current situation of general practice teacher,the need of general practitioner of general practice teacher,general practitioner training related expert and the demands of community resident for general practitioner in Shandong province.We can find the main problem of the general practice in China and provide a good reference for the construction of the general practice base.Methods1 By reading the relevant literature domestic and international to know the situation of general practice;2 A questionnaire survey was conducted on general practice teacher,general practitioner,general practitioner training related experts and community resident in Shandong province to understand the current situation of general practice teacher,the need of general practitioner of general practice teacher,the advice on general practice teachers’ training of general practitioner training related expert and the demand of community resident for general practitioner.Results1 By reading the literature of general practice domestic and international.In Australia,the United States,there has been established perfect general practitioner training base,formulated the general practitioner training plan in detail,and have special agencies to irregular general practitioner training.These countries also have perfect training system for the general practice,and there are special institutions for the regular evaluation of all medical teachers.In our country,there is strict selection criteria for the general practice base.The training program for general practitioners is perfect.However,the access,authentication,evaluation system of general practice teacher is imperfect,the teacher in general medicine become the bottle-neck of the development of the general practice.2 By investigating 510 general practice teachers in Shandong Province,the profession of general practice teachers in Shandong province are mainly concentrated in internal medicine(42.5%),general practice(14.7%),surgery(8%),emergency department(6.1%),department of geriatrics(5.3%).The main types of teachers are divided into clinical base specialist teacher(51.8%),clinical base general practice teacher(42.4%),community practice base teacher(25.7%),the general practice theory teacher(18.2%).The form of qualification certification is mainly concentrated in the provincial and above teacher training courses(38.4%),junior college teachers part-time(23.9%),the base of hospital teacher training courses(22.9%).General practice teacher think the minimum of bachelor degree for tutors(87.1%),the lowest for the title doctor is attending doctor(93.5%),a general practice teacher must have experience of teaching general practitioner(58.8%),the time of teaching for two years(53.3%).The access of general practice teacher is recommendation of the base(55.9%),and the training of general practice teacher is network teaching(50.8%),and the examination of general practice teacher is open book examination(50.8%).General practice teachers who is involved in teacher training,the training focus on the general theory of training(84%),the clinical skills(75.3%),general medicine teachers believe that the current main emphasis of teacher training in general medicine is the general theory of training(89.2%),clinical teaching skills(81.0%).3 By investigating 203 general practitioners in Shandong province,the profession of general practitioners mainly focus on internal medicine(39.9%),general practice(26.6%),department of traditional Chinese medicine(7.9%).The type of training general practitioner mainly focus on standardized training of general practitioner(40.9%),transfer training(35%).The main reason of community resident for medical diagnosis(80.8%),health consultation(26.6%),prescription(22.2%).General practitioner believe that the minimum degree of general practice teacher is undergraduate(70%),the lowest title of general practice teacher is attending physician(72.9%),the general practice teacher should have a professional teaching experience and general teaching experience(69%).93.1%general practitioners believe that the general practitioners who have finished the training should be re-trained,the time of retraining is 1 years(35%).The form of retraining is a short course(66.5%).4 By investigating 43 general practitioner training related experts,general practitioner training related experts think that the minimum degree of tutor is undergraduate(65.1%),the lowest title of general practice teacher is vice director and above(58.1%),the minimum time of teaching is three years(44.2%),the way of training tutor is short-term courses(72.1%),the assessment method of general practice teachers is open-book examination(60.5%).5 By investigating 158 community residents in Shandong Province,the satisfaction of community residents to the work ability of the community general practitioners is 65.2%.The reason of community residents to seek help of the community physicians is mainly the diagnosis and treatment of diseases,medication and disease counseling,38%community residents just know little about the concept of general practitioners.87.3%community residents believe that it is necessary to set up a general practitioner.Community residents believe that the quality of the general practitioner is mainly focused on the sense of responsibility,love and compassion(93.7%),comprehensive medical technology(84.2%),the main responsibilities of general practitioner is diagnosis and treatment of diseases(88.6%),the residents’health management and consulting(84.8%),the area that the general practitioner should improve is daily outpatient(81%),prevention and treatment of chronic diseases(77.8%)and daily health care knowledge education(65.8%).conclusionsThe training system of general practice has been developed for 30 years in the United States,Australia and the United.They have established a perfect functional,appropriate scale,institutions for the general practice education system.The construction of general practice teacher plays an important role in the training system of general practice.The training system of general practice can meet the needs of social basic medical service.However,the general practitioner in our country is still far from reaching the basic medical and health needs of our communities.Although the general practitioner training base of our country has strict criteria and the detailed training plan for general practitioners,but our teachers in general medicine access,authentication,evaluation system is not perfect,as the dominant factor of the base in general medicineBy investigating 510 general practice teachers,203 general practitioners,43 general practice training related experts,and 158 community residents in Shandong province.The current backbone of tutors is college teachers,the professional of general practice teacher mainly concentrate on internal medicine,surgery,emergency medicine,the department of geriatrics.The type of general practice teacher focus on the clinical types of base college teachers.College teachers’ understanding of general medicine teaching is not enough,they do not familiar with general practitioners and can not use the thinking and method of general medicine to guide the general practitioner.But college teachers has better teaching ability and knowledge system than others,so we should give full play to the advantages of college teachers in the process of the practitioner training and strengthening the training of college teachers of general thinking.The certification system of the general practice teachers are not unified,the training system is not perfect,the assessment system is not perfect,the supervision system is not established.We should improve the access,certification system,the training system and the evaluation system,And we should establish a sound supervision system to ensure the quality of tutors and the quality of general practitioners.Although the current backbone of tutor is college teachers,but the number can not meet the needs of general practitioners.We should establish a sound policy of talent support to attract outstanding teachers with professional teachers to teach.At present,general practitioner mainly from the reorientation of physician,the community general practitioner,the town-ship general practitioner and the resident standardized training of physician.In order to ensure the quality of the training of general practitioner,we should establish a strict access threshold of general practitioner,develop medical postgraduate education to improve the education level of general practitioner.We also should complete the general practitioner resident standardized training of general practitioner services in primary health care institutions,the original unit would not like to send the general practice into the training base to be re-trained,the general practitioner knowledge can not be updated,so we should establish a perfect training system.We also need to increase the awareness of general practitioner and general practitioners of the concept of publicity. |
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