| Objectives By comparing the training effectiveness of appropriate health technique of "Tenth Five-Year Plan" with the chronic appropriate health technique of "Eleventh Five-Year Plan ", explore the influencing factors of training effectiveness. The study can provide a scientific basis for improving the mode of training and the training effectiveness of appropriate health technology.Methods Collect the data of training effectiveness of appropriate health techniques of both "Tenth Five-Year Plan" and "Eleventh Five-Year Plan":(l)Training pattern: Gathered-training pattern was used to train 10 Province-level and 5 state-level appropriate health techniques. (2) Comparative study on training effectiveness of the two plans: Comparing with The Tenth Five Year Plan, large improvement was made in experimental county, personnel, training pattern, expert source and appropriate techniques in Eleventh Five Year Plan.(3)Investigation on training effectiveness:①Objective evaluation on training effectiveness: By comparing the changes of average scores before training, after lecture-training and interaction strengthening of each technique, training effectiveness was estimated objectively.②Subjective evaluation: Training Effectiveness Questionnaire was used to investigate student's knowledge on training contents of each technique. (4) Study on influencing factors of training effectiveness:①By layering technical type, we analyze the influence of technical type to student's technical requirement, cognitive of the difficulty degree and satisfaction degree of post-interaction strengthening by experts.②By studying on student quality and professional background, understanding their Influences on technical requirement, cognitive of pre-training and the difficult degree, learning scores and mastery degree on knowledge. Analyze influences of expert title, teaching method and organization management on training effectiveness.Results (1) Comparative Study on training effects of two projects:①Compare with experimental county and personnel: there were only county and country grade medical Professional of two experimental county during The Tenth Five Year Plan. But The eleventh Five Year Plan enlarged medical Professional of county village grade of five experimental county and the coverage rate of village clinic reached 62.76%.The two projects differences had statistical significance in educational background, title and work unit grade of the technician (P<0.01).②Training pattern and expert source: the training pattern used gathered-training, expatriates-training and on-spot-training during The Tenth Five Year Plan. But training pattern of the cadres' status and types was applied during The Eleventh Five Year Plan, including invite seven techniques destinations experts and fourteen autres experts.③Appropriate techniques: training techniques of The Tenth Five Year Plan project, including 26 medicine techniques, come from the Chinese Ministry of Health and nation's traditional Chinese medicine office. The training techniques includes 21 medicine in which 10 comes from the Chinese Ministry of Health and nation's traditional Chinese medicine office, and 11 autres self chosen during The Eleventh Five Year Plan. (2) The current situation of trained medical technician:①Scientific research innovation: scientific research ability of technician had great differences among province, county and village levels medical institution (P<0.01). Scientific research ability of county-level doctors were better than country-level and village-level doctors, village-level doctors was the worst .②The ways to acquire new knowledge: County-level technician is mainly to training (61.54%) , self-study on books and newspaper (61.54% )and network( 57.69%).Country-level doctors depend mostly on network (62.10%) , training (61.29%) and self-study on books and newspaper (53.23%) .The ways for Village-level doctors mainly is self-study on books and newspaper (61.37%) , broadcasting television (44.46%) and network (34.26%) . (3) Training effects:①Learning effects: 1) Province-level Training :the average scores were elevated greatly from pre-training to post-lecture (P<0.05) .Average scores of appropriate techniques on western medicine at three training periods were 41.34.65.45 and 65.74 respectively. Among western medicine techniques, the average scores of standardized therapy for hepatitis B at three training periods were all lower than 60, and scores of standardized therapy for hypertension had the greatest increase (36.94). Average scores of 5 items Chinese medicine appropriate techniques at post-lecture and post-interaction strengthening were increased up to 28.76 and 36.95 compared with the scores at pre-training respectively, the differences both had statistical significance (P<0.01). 2) County-level Training: The average scores of village doctors were elevated 22.05 after training. Among western medicine techniques, the average scores of rural cancer pain three-step analgesic scheme at different training periods were all lower than 60. Clinical application for catgut implantation at acupoint had the lowest Score (63.40) after post -interaction strengthening.②Mastery degree on techniques: 1) Province-level training :The differences of student's mastery degree on 5 items western techniques had statistical significance (P<0.05). The order of skillful in appropriate techniques was in sequence of prevention and treatment of diabetic foot and standardized applying of insulin (33.77%), standardized therapy for hypertension (32.47%) , promotion of standardized therapy program for chronic bronchitis and pulmonary heart disease (30.26%) , and promotion of standardized therapy program for hepatitis B (29.87%) .The differences of student's mastery degree on 5 items Chinese medicine techniques hadn't statistical significance (P>0.05). 2) The county level training: After the village doctor were trained 3 times of the Appropriate Technique of Western Medicine, there was significant difference on their grasp the technique (P<0.05).The technique which trainees could skilled use after training are the extension application of the standardized diagnosis and treatment methods of chronic bronchitis and pulmonary heart disease (9.02%), the standardized treatment of hypertension (5.72%), the extension application of the three ladders of analgesic method in patients with cancer pain in rural areas (3.52%).There is no significant difference between the situation trainees grasp with 2 techniques of Chinese medicine (P>0.05).(4) Influencing factors of training effects.①Type of appropriate techniques: Trainees had the highest demand of appropriate techniques on western medicine (Z=23.33, P<0.01), they grasp the appropriate techniques of western medicine better than that of Chinese medicine (Z=-10.48,P<0.01). Meanwhile, techniques on western medicine was more difficult than ones of Chinese traditional medicine (Z=18.11, P<0.01).②Background of trainees' major: the higher of trainees' titles, education and hospital's grades, the greater demand of appropriate techniques, the better grasp with the techniques and the lower demand of retaining.③Title of teachers: The higher the title of teacher was, the greater trainees' satisfactory rate to the teacher's lecture was (r_s=0.13, P<0.01).④Way of teaching: There is significant difference among the trainees' satisfactory rate to the experts 'lecture between the appropriate techniques of western and Chinese medicine (P<0.05) ,while there is no significant difference among the trainees' satisfactory rate to other two ways of teaching (P>0.05 ) .⑤Rate of trainees who are satisfied with the management of training organization, the rationality of course offering and the fitness of course content are 74.79%, 78.52% and 78.88% respectively. It is only 45.72% trainees are satisfied with the teaching environment and equipment installation.Conclusion (1) The training of "the eleventh five-year plan" of appropriate health technique in Gansu province has made great improvement compared with that of "the tenth five-year plan". The training has expanded the scale, established policies of constrains and encouragement, used the training rating and made trainees' major be fit for their training contents. Also, from combing the state techniques and selected techniques in province, the experts who come from inside and outside province, an expert source which belongs to Gansu province was established. Meanwhile, enhance the publicity of the appropriate techniques and set up the popularization and application stage of the appropriate techniques on internet. (2)Training of chronic disease appropriate health techniques in rural areas in Gansu province achieved excellent effects. The trainees have grasped the techniques which are simple, efficient, economical, effective and appropriate used in local common chronic disease. The trainees' knowledge and professional qualities have improved obviously. In the future training, we should according to the technique characteristic, equipment demand, capability of training organization, teachers, the trainees' qualification and quantity etc, choose the appropriate training methods which suit to the local condition, extend the training time and limit the number of trainees in 30-50 per class.(3)This paper shows us that trainees title, education, major, hospital's grades, teacher's title, the technique its own characteristic ,the way of teaching ,management of training organization etc, have influence on the effective of the training techniques in varying degrees. Aiming at these influence factors mentioned above, we should formulate strict training rules and make the limited training resource yields the most benefit in the future training popularized of the appropriate health technique in rural areas.
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