| ObjectivesThe purpose of this study is to explore whether a teaching mode meeting the actual demand, and to improve problems existing in the current diploma education, through analyzing the current teaching condition of the diploma of the junior-grade medical technical personnel in medical technical secondary school and its existing problems.MethodsA reference to secondary technical school enrollment notice and teaching program of 2005 and 2006 grass-roots health professionals of Health Department of Henan Province shall be made to collect the enrolment and specialized subjects of 20 secondary vocational health schools in 2005 and 2006, as well as courses and class hours of every specialized subject and arrangement of qualified teachers; a reference to 2006 diploma education documentation of rural health personnel in Henan province and 2007 general meeting minutes of training of grass-roots health professionals in Henan province shall be made to gather the number of non-credit grass-roots health professionals in Henan in 2005 and 2006 who participated in the training and of those who obtained the academic credentials. The stratified cluster sampling shall be made in different specialties for grass-roots health professionals who participated in the provincial graduation examination in July 2007 to select survey objects. Only one school across the province has its students in different specialties, stomatology for instance wholly surveyed; As for the specialties offered by a number of schools, school -based cluster sampling shall be adopted to sample the total students (including those wholly or partly released from productive labor) in every specialty in one school. A total of 774 grass-roots health professionals were selected from 7 different specialties of 4 secondary vocational health schools.Questionnaire shall be conducted during the period of the general graduation examination of grass-roots health professionals from every school. The survey interviewers shall make clear the survey objective and instruct them to fill the questionnaire and take back it immediately after filled. As of July 2007, qualified questionnaires that are taken back totaled 765. In September 2007, the questionnaires that were finally satisfactory to the requirement totaled 759 after approved by the Department of Science & Education of the Health Department. Epidata database was set up for all the findings, which are subject to statistical analysis with SAS9.13.Results1. Current Condition of Henan Junior-grade Health Technical Personnel with a Diploma of Secondary Technical School Education1.1 Courses Setting in Each Major and Their HoursAccording to the arrangement of education and teaching program of academic diplomas of grass-roots health professionals in Henan province, every specialty offers special courses, basic courses in discipline, basic medical program, Chinese medicine knowledge, Knowledge of community health services, health law and regulation, medical psychology and medical ethics and practical teaching. However, the teaching content is more while the class hour is less. 1.2 Characteristics of Training InstitutionsHenan Health Office fully used the resource of the secondary occupational health school to appoint the qualified secondary health schools as training institutions since 2004. Henan secondary health schools have full teaching conditions, and each school basically has better teaching buildings, laboratory buildings, apartment buildings for students, and other auxiliary rooms. Most schools have their own distinctive majors, preliminarily forming a major network with matching majors and mutual cooperation in the whole province. But these schools all locate in prefecture-level cities. The teachers and fields became strenuous due to the expansion of students recruiting scale in recent several years.1.3 Condition of Teachers in Training InstitutionsAll of the four schools which were surveyed this time assigned senior lecturers and "double-role" teachers give lectures of major courses.1.4 Length of Schooling and School TimeThe learning form of the secondary technical school education for grass-roots health professionals is subject to one-year wholly-sabbatical or two-year partially-sabbatical from work. The school time of full-time class is in conflict with that of student of the general secondary technical school. The part-time class gives lessons in summer holiday.2. Basic Condition of Junior-grade Health Technical Personnel Investigated2.1 Sex structure: there are 324 males ,434 females among junior-grade health technical persons, the ratio of male and female is 0.75:1 .2.2 Age structure: among junior-grade health technical students, there are 223 persons of the group of 20-29 years old ,as 29.38%; 372 persons of the group of 30-39 years old ,as 49.01%;134 persons of the group of 40-49 years old ,as 17.65%; 30 persons of the group of 50-60 years old ,as 3.95%.2.3 Title structure: there is only one student with a senior professionals 0.13%;40 students with secondary professional ,as 5.27%;70 students with junior professional ,as 9.22%;648 students with no professional ,as85.38%. the ratio of junior, medium, and senior is 70:40:1.2.4 Structure of length of schooling: 501 students selecting the release studying mode among junior-grade health technical persons, accounting for 66.62%; 251 ones selecting the partly release studying mode, accounting for 33.38%.2.5 Major structure: 289 students in the community medicine major among the investigated junior-grade health technical persons, accounting for 38.08%; 65 ones in the nursing major, accounting for 8.56%; 66 ones in the preventive medicine major, accounting for 8.70%; 137 ones in the oral medicine major, accounting for 18.05%; 53 ones in the clinical examination major, accounting for 6.98%; 88 ones in the medical image major, accounting for 11.59%; 61 ones in the medicament major, accounting for 8.04%.3. Condition on Feedback of Investigated Junior-grade Health Technical Personnel on School Education and Teaching Management3.1 Teachers collocation and teaching mode: the difference on students' satisfaction and dissatisfaction with teachers and their teaching modes has a statistical significance (P<0.05). Aspects in which the teachers and their teaching modes are satisfied: great learning, abundant experience, patience, responsibility, questions-answers, prominence giving to important points, full explanation on difficult points, lively talk, active classroom atmosphere, inferring on the whole from a single instance, and familiar with the outlines and contents of the public graduation examination and the national licensing examination for physician assistant. Dissatisfactory aspects are: colorless teaching talk, short of practical experience, no communication with students, cramming teaching, unclear black board writing, lack of consecution, and dated knowledge.3.2 Courses setting and hours: the courses that students in each major think to be mostly helpful to them and rank as top three are those having close relation to the specialties they engage, and also those for which they wish to increase some hours. 3.3 Attendance situation: the average attendance rate in the community medicine major is 83.92%, and it is 51.39% in the nursing major, 56.92% in the preventive medicine major, 71.60% in the oral medicine major, 65.00% in the examination major, 76.37% in the medical image diagnosis major, and 87.00% in the medicament major.4. Self-assessment of Students4.1 Learning goal: most of total junior-grade health technical persons investigated have definite goals that are in order: increase the professional qualification, gain the license, and achieve the diploma of secondary technical school. 56 among them think to be convenient to promote the post, accounting for 7.38%; 12 only have unclear objectives, accounting for 1.58%.4.2 Reasons for students to difficultly learn: the reasons that junior-grade health technical workers in each age group think hard to learn are in order: no full time to listen teaching, weak memory, weak cultural foundation, difficult understanding and ill-suited specialty, which respectively account for 55.86%, 49.01%, 23.19%, and 4.35%. The difference of reasons of students in each age group to think learning hard has a statistical significance (P<0.05). For those not having full time to listen, the constituent ratio becomes lower and lower with the age increasing; the constituent ratio of those with a weak memory becomes higher and higher with the age increasing.4.3 Absence situation: the difference of absence situation of each age group has a statistical significance (P<0.05). The number of absentees becomes lower and lower with the age growth, and it is the biggest in the group with an age of below 30, accounting for 65.16%, and the least in the group with an age of 50 and above, accounting for 40%.The main reasons for absence of students in each major are in order: busy work, no time,as 83.40%; far from the school,inconvenient to have meals and live, as 27.67%; much housework, as 26.09%; no support from the unit, as 10.54%; unwealthy,as 9.88%.4.4 Self-assessment on learning effects: the difference of students in the aspect of increase or reduction of their professional levels in each major has a statistical significance (P<0.05). The increase or reduction of the professional levels of students with different length of schooling has an obvious difference (P<0.05), the number of partly release students thinking an increase is larger than that of the full release.Conclusions1. The education for Henan junior-grade health technical personnel with a diploma of secondary technical school education is a "grown-up" , "in-service" , and "non-zero base" education, with a short length of schooling and much contents in professional courses as well as short hours, training institutions all are secondary occupational health schools.2. The investigated junior-grade health technical personnel all are adult with reasonable age and sex structures, the ratio of female rural doctors has increased obviously, and the difference in the sex structure of each major has a statistical significance. Most students in each major have no professional titles with a wholly weaker qualification. Most students select the full release learning mode.3. The problems existing in the teaching and management of the education of Henan junior-grade health technical personnel with a diploma of secondary technical school education cannot gain the attention of leaders in partial units; the teaching organization mode is excessively centralized; the teaching methods of teachers in certain majors are not better; in courses setting, the professional courses have much contents but with short hours; the school time for students in full release class conflicts with that of the common students, the fields in training institutions are limited, and teacher resources are strenuous;the lower rate of present in some proffession.4. The main reasons for Henan junior-grade health technical personnel to be absent in joining in the education with a diploma of secondary technical school are in turn: busy work, inconvenient to have meals and live, much housework, no support from units, and unwealthy . |
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