Background
Methods
Ethics statement
Sampling methods and participants
Data collection and quality control
Statistical analysis
Results
Characteristics of doctors
Doctors (NO.%) |
P
| ||||
---|---|---|---|---|---|
Eastern | Central | Western | Total | ||
CHSIs Number | 94(48.9) | 47(24.5) | 51(26.6) | 192(100) | |
Gender | 0.195 | ||||
Male | 684(38.8) | 212(39.3) | 288(39.2) | 1184(39.0) | |
Female | 1078(61.2) | 328(60.7) | 447(60.8) | 1854(61.0) | |
Education level* |
< 0.001
| ||||
Undergraduate and above | 837(47.5) | 229(42.4) | 434(59.0) | 1500(49.3) | |
Junior college | 593(33.7) | 236(43.7) | 196(26.7) | 1025(33.8) | |
Technical secondary school/ High school | 313(17.8) | 73(13.5) | 105(14.3) | 491(16.2) | |
Below high school | 19(1.1) | 2(0.4) | 0(0.0) | 21(0.7) | |
Title level# |
< 0.001
| ||||
Senior title | 214(12.1) | 59(10.9) | 119(16.2) | 392(12.9) | |
Middle title | 657(37.3) | 152(28.1) | 277(37.7) | 1086(35.8) | |
Junior title and below | 786(44.6) | 275(50.9) | 291(39.6) | 1352(44.5) | |
No title | 105(6.0) | 54(10.0) | 48(6.5) | 207(6.8) |
Training status
Differences | Postgraduate residence training program | On-the-job training program/job-transfer training program | Train-the-trainer training program | Training program held by CHSIs |
---|---|---|---|---|
Target population | Graduates whose medical background is 5- to 8-year post–high school education or over, and who are likely to choose general practice as a career. | Community health physicians with 3- to 5-year post–high school medical education, who are willing to become general practitioners by on-the-job training. | Clinical faculty from hospital, clinical faculty from CHSIs and theoretical faculty from university | Doctors working in CHSIs. |
Teaching contents/curriculum | (1) Hospital-based Clinical rotation; (2) CHSIs-based training. | (1) Academic curriculum; (2) Hospital-based clinical rotation; (3) CHSIs-based training. | (1) Task responsibilities and contents for GP faculty; (2) Clinical teaching contents and methods; (3) Theoretical knowledge and clinical skill; | Basic medical services, chronic management, preventive care, etc. |
Training lengths | 33 months (full-time) | 12 months (full-time) | 2 months | Irregularly scheduled |
Type of certificates obtained | Standardized residency training certificate which is issued by Ministry of Health and is a prerequisite for the qualification of GP. | GP on-the-job training certificate which is issued by provincial health department. | GP faculty training certificate which is issued by provincial health department. | None |
Type of training program | Doctor (NO.%) |
P
| ||
---|---|---|---|---|
Eastern | Central | Western | ||
On-the-job training | 869(49.3) | 232(43.0) | 260(35.4) |
< 0.001
|
Postgraduate residency training | 137(7.8) | 13(2.4) | 50(6.8) |
< 0.001
|
Job-transfer training | 170(9.7) | 56(15.9) | 77(10.5) |
< 0.001
|
Train-the-trainer | 361(20.5) | 118(21.9) | 133(18.1) | 0.349 |
Training held by the CHSIs | 776(44.0) | 161(29.8) | 209(28.4) |
< 0.001
|
Doctor (NO.%) |
P
| |||
---|---|---|---|---|
Eastern | Central | Western | ||
Training topics | ||||
Basic clinical theory knowledge | 880(52.4) | 272(50.4) | 333(45.3) | 0.081 |
Clinical practice skills | 898(51.0) | 282(52.2) | 337(45.9) |
0.034
|
Community health service competency | 908(51.5) | 322(59.6) | 314(42.7) |
< 0.001
|
Preventive care | 364(20.7) | 128(23.7) | 145(19.7) | 0.200 |
Training problems | ||||
An excessively short training time | 649(36.8) | 197(36.5) | 291(39.6) | 0.379 |
Insufficient training content | 575(32.6) | 181(33.5) | 219(29.8) | 0.284 |
Deficiency in clinical practice skills | 451(25.6) | 156(28.9) | 182(24.8) | 0.215 |
Insufficient resolution of problems at work | 465(26.4) | 143(26.5) | 182(24.8) | 0.674 |
Knowledge needs | ||||
The updated international medical knowledge | 1406(79.8) | 427(79.1) | 532(72.4) | 0.066 |
The updated domestic medical knowledge | 1357(77.0) | 422(78.1) | 538(73.2) |
< 0.001
|
Clinical experience | 549(31.2) | 201(37.2) | 206(28.0) |
0.002
|
Clinical decision making | 488(27.7) | 164(30.4) | 183(24.9) | 0.092 |
Clinical medication | 462(26.2) | 162(30.0) | 195(26.5) | 0.213 |
Skill needs | ||||
Communication skills | 1481(84.1) | 446(82.6) | 569(77.4) |
< 0.001
|
Diagnosis and differential diagnosis | 1446(82.1) | 442(81.9) | 575(78.2) | 0.074 |
Physical examination | 1385(77.1) | 407(75.4) | 509(69.3) |
< 0.001
|
Observation skills | 1335(75.8) | 406(75.2) | 519(70.6) |
0.024
|
Clinical medication use | 1317(74.7) | 401(74.3) | 502(68.3) |
0.003
|