| Objective:From the perspective of the trainee,to analyze the implementation status of assistant general practitioner training deeply in Yunnan Province,find out the existing problems,understand the satisfaction of trainees on assistant general practitioner training,and find out the factors affecting trainees’ satisfaction.Guided by improving the quality of assistant general practitioner training,Combining with the actual situation of Yunnan Province,put forward targeted improvement strategies and suggestions.It can provide reference and basis for the relevant departments in Yunnan Province to further improve the assistant general practitioner training system.Methods:The stratified cluster sampling method was adopted in this study.A total of 325 trainees who are participating in the training in 2018 and 2019 grade from 8 Yunnan Province assistant general practitioners training bases were selected as the survey subjects.The self-made questionnaire "Yunnan Province assistant general practitioners training status questionnaire(trainees)" was used to conduct a satisfaction survey.And 35 trainees and 8 managers of science and education departments were randomly selected for on-site interviews to fully understand the implementation of the training and the objective evaluation satisfaction index.After sorting out the collected questionnaires,EpiData3.1 database was used to establish the database and input the survey data.SPSS26.0 statistical software package was used for data analysis and processing.The measurement data were statistically analyzed by t test,ANOVA,factor analysis and multiple linear regression.Enumeration data were statistically analyzed by chi-square test and rank sum test.The qualitative data were summarized and the interview topic was refined.Results:1.All training bases carry out assistant general practitioner training in accordance with the relevant documents issued by government departments,but in practice,the connotation construction of the bases is relatively weak,and the infrastructure,teachers’conditions,assessment arrangement,organizational management of the bases have not been homogenized.2.In terms of the awareness of training policies and regulations,The trainees’awareness of training policies and regulations was 47.35%,and the gender difference was statistically significant.Maletrainees were more aware of training policies and regulations than female trainees.3.In terms of the understanding of training standards,50.00%of the trainees knew the training standards,and nearly half of the trainees did not know the training objectives,content and requirements,training details,etc.whether the training standards are known or not will directly affect the training enthusiasm of the trainees,and then affect the training quality of the assistant general practitioners.4.In terms of the evaluation of the training necessity,all the trainees believed that it was necessary to carry out the training of assistant general practitioners,among which 66.14%believed that it was of great significance.This reflects the great needs of trainees for training and the urgent requirements for improving their own level.5.In terms of the attention on training,trainees themselves paid more attention to the training of assistant general practitioners than the bases,with the rate of great attention reaching 44.13%.And the lower grades paid more attention to the training than the higher grades.This reveals that the learning attitude of the training subjects is positive,but the training base is lax.6.In terms of skills improvement,trainees’ choice rates of improving their medical humanities and communication ability,clinical diagnosis and treatment skills,general practice thinking and basic public health service ability during the training period were 83.02%,79.82%,74.23%and 64.60%,respectively,and the choice rate of basic public health service ability was the lowest.The difference of gender,base nature and training identity in skill improvement was statistically significant.7.Regarding the problems in the training of assistant general practitioners,the trainees believed that the biggest problem was that the teaching ability of the base was not high.The trainers was the key to ensure the effectiveness of the training,so it is urgent to strengthen the training and management of teachers.8.In terms of professional identity,65.09%of trainees had made career plans for themselves,which would help them strengthen their determination to work at primary health care institutions76.40%of trainees were willing to engage in primary health care after the training.The clearer the career planning is,the higher the sense of professional identity will be,and the firmer their willingness to work at primary health care institutions will be.9.In terms of training satisfaction evaluation,the overall satisfaction score of trainees was 3.48,which was between "average" and "relatively satisfied".Among the 19 scoring items,base construction was the most satisfactory(3.75±0.88),while salary was the least satisfactory(2.66±0.10).Through factor analysis,four dimensions of organization management,faculty condition,assessment management and economic security were summarized,among which the highest score was assessment management,and the lowest was economic security.Through multiple linear stepwise regression analysis,gender,base attributes and whether it is demand-oriented rural medical trainees were the main factors affecting the trainees satisfaction.Male trainees had a higher satisfaction on the training of assistant general practitioners than female trainees,state and municipal base trainees had a higher satisfaction on the training of assistant general practitioners than county base trainees,and demand-oriented rural medical trainees had a higher satisfaction on the training of assistant general practitioners than non-demand-oriented rural medical trainees.10.Both the trainees and the managers of bases expressed their views on the training content.The training contents was not fully and thoroughly implemented,which needed to be strengthened and improved.The assessment arrangement of the department was not reasonable,the base arranged for itselfs,and the assessment homogenization has not yet been realized.The conditions of hardware facilities were different among different bases,and there were many old and incomplete hardware facilities in county-level bases.The overall teaching level of teachers was not high and the teaching attitude was not active.Therefore,it is urgent to strengthen teacher training and team construction to ensure the training quality.Most trainees reflected that the treatment of trainees was too low to basically guarantee the survival needs of trainees.Conclusion:1.Yunnan assistant general practitioner training base organization management and work arrangement is uneven,the arrangement among bases is lack of uniformity.It is suggested to improve the training organization and management of assistant general practitioners in the base and strengthen the students’ learning of the training content.2.The overall teaching level of teachers is not high,and the training base is in urgent need of strengthening the construction and management of teachers.To realize the homogenization of teacher training and assessment as soon as possible,we can ensure that the quality of grassroots general practitioners trained is sufficient and excellent.3.The assessment arrangement of assistant general practitioner training process is unreasonable and needs to be further improved.The promotion of training policy should be strengthened and the training of assistant general practitioners should be paid more attention.4.The trainees’ satisfaction with economic security dimension is the lowest,and the economic input needs to be further strengthened.The government should increase economic investment and improve the treatment of assistant general practitioners. |
PDF Full Text Request