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The cultivation of students majoring in clinical medicine (rural doctors) is an important measure to promote the health construction at the grassroots level in Xinjiang. The cultivation of talents in this profession is closely related to the educational management mode. In view of the problems in the management and training of rural doctors, this paper explores the improvement methods, aiming at constructing the dual-cycle management system (big cycle management system and small cycle management system) of clinical medicine (rural doctors) from the perspective of management. The big circulation management system is the main body, the small one is the key point of the college management, and the two circulation management systems promote each other, trying to construct the talent management and training system of the trinity of college education, graduation education and continuing medical education. With the support of this system and the advantages of the same counselor in cycle management of students in different grades and different periods, the communication between the counselor and the class teachers, students and students of all grades can be increased. In this way, counselors, class teachers and students of all grades can have a more intuitive and in-depth understanding of the curriculum and internship and employment situation of this specialty, and provide reference for improving the management education level of students majoring in clinical medicine (rural doctors).
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Objective:To investigate the correlation of rural doctors' service ability and interest demands,and analyze the countermeasures for improving the service capacity of rural doctors from the perspective of the personal interest demands of rural doctors. Methods:Through the combination of qualitative and quantitative research meth-ods,we described the current situation and correlation of rural doctors'service ability and interest demands. Result:The interest demands of rural doctors mainly included raising the level of old - age insurance,increasing economic subsidies,clarifying the position of rural doctors,increasing the training opportunities and solving practice risk. These five demands had different level effect on the service ability of rural doctors. Conclusion:It should compre-hensively promote the progress of rural integration,improve the rural doctor's economic subsidies and pension secu-rity level and integrate rural doctor into medical and health system;establish a rural doctor' risk sharing mechanism to solve the practice risk of rural doctors;optimize the training mechanism for rural doctors to improve the technical level of rural doctors.
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Objective To explore the insertion of the teaching contents of nursing in rural doctors'higher education,so as to increase their understanding of medical knowledge and improve their medical skills.Method 90 rural doctors of Grade 2014 were chosen as the research object,and according to their willingness to participate,they were divided into control group and observation group.The students in the control group were mainly taught by the relevant knowledge of clinical medicine,while nursing teaching content was inserted in the teaching of observation group.In the teaching process,firstly,the teaching contents of nursing were reorganized,and then the teaching content of clinical medicine was taken as the main line,according to the development of teaching content,flexibly inserting nursing teaching part.The results of the final examination of the internal medicine of the two groups were compared and the specific learning experience of rural doctors was investigated.SPSS 20.0 was used to analyze the data,the count data was expressed as percentage,and chi square test was performed.Results The number of students in the control group and the observation group whose subjective score was more than 40 was 17.65％ and 48.72％ respectively.The number of students scoring ＜30 points accounted for 23.53％ and 5.13％ of the total number of students,and there was a statistically significant difference between the two groups(P＜0.05).The observation group had a better learning experience,and had little influence on the learning of clinical medical knowledge.Conclusion In the stage of education for rural doctors,inserting the teaching contents of nursing can improve the teaching effect.
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Objective To identify the influencing factors for rural doctors′ training effect,and suggest on the improvement of such training.Methods On the basis of rural doctors′ survey,the theory of pre-intervention was used to probe into the influencing factors for such training in five dimensions of attention notice,mega-cognitive strategies,advance organizer,goal orientation,and preparatory information.Results 73.2% of the groups were found with satisfying effect.In the single factor analysis,comparison of training effect involving such factors as age,gender,length of work life and pre-intervention revealed statistical significance(P<0.05).As shown in the logistic regression analysis,High motivation in meta-cognitive strategies,Clear goals in goal orientation,Tiered and categorized training in advance organizers,and Practical learning in preparatory information,as well as variants like age would influence rural doctors′ training effect significantly.Conclusions The key to better training effect lies in better motivation of the trainee,setting correct training goals,emphasis on the practicability of training contents and,the pertinence of the training objects.
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OBJECTIVE:To provide reference for implementing relevant policies and measures,and promote rational drug use. METHODS:The cognition(questionnaire)and application(prescription spot checks)about antibiotics and glucocorticoids by 191 rural doctors from 14 township hospitals and 18 health room in area A,B and C(representing the economically developed areas, moderately developed areas and undeveloped areas)were investigated,and the results were statistically analyzed. RESULTS:Total-ly 382 questionnaires were sent out(191 for antibiotics and 191 for glucocorticoids),and 382 were effectively received with effec-tive recovery of 100%;and 2 300 prescriptions were checked. Results of questionnaire showed,there were still some misunder-standings and blindness among the rural doctors'cognition and application about antibiotics and glucocorticoids,the usage of β-lac-tam was not fully grasped,part of the empirical use of antibiotics and drug treatment was still not entirely clear,more than 40%had no clear ideas about the classification and contraindications of hormones,and more than half of them didn't know the Glucocor-ticoids Clinical Practice Guidelines;results of prescription spot checks showed,there were regional differences about the proportion of antibiotics and glucocorticoids,area A had the highest proportion among 3 areas,accounting for 60.9% and 18.9%,respective-ly. And area C showed highest proportion about unreasonable prescriptions,accounting for 22.5%. CONCLUSIONS:The cognition and reasonable use of rural doctors for antibiotics and glucocorticoids still needs to be strengthened. It is suggested to take effective measures,formulate and implement the corresponding supervision system,strengthen antibiotics and glucocorticoids knowledge training for rural doctors and fully implement the the principles of rational drug use to improve the rational drug use.
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Objective To study and identify factors and evaluation criteria for optional health policy instruments for policy making reference.Methods A field survey was made to the10,000 primary care doctors to rural households campaign in Jining city,covering 453 doctors sent to villages,294 village doctors,and 572 rural residents,with the data obtained subject to descriptive analysis.Results In terms of equity of the campaign,97.8％ of the rural residents have entered into agreements,and 1.715 million of free visits have been provided by family doctors; in terms of economics,most of the superior doctors,rural doctors and rural residents believed that the policy could encourage high quality resources to sink to rural areas,and enhance the competence of public health services by rural doctors.In terms of the adaptability,60.4 ％ of the superior doctors and 92.7％ of the rural doctors hold that they are competent for health care role,but 51.8％ of the superior doctors were found not used to the current working mode.In terms of the enforceability,main complaints of superior doctors and rural doctors were excessive workload,overlong working hours,insufficient medical equipments,and reduced institutional revenue In terms of acceptability,90.4％ of the rural residents are supportive Conclusion The promotion of such a policy calls for a combination of compulsory,voluntary and mixed policy instruments in sinking the resources,with appropriate selection and optimization of such instruments,to ensure outcomes of the policy.
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Objective To understand the work tasks of rural doctors in our country and to provide bases for the reforms of clini‐cal medical education of junior colleges .Methods A self‐made questionnaire was performed in 1 245 rural doctors from 86 rural grassroots health institutions in 7 provinces/municipalies of our country .Results The academic levels of rural doctors were low (65 .54% )and the rates of their medical certification holding were low in western district(7 .79% ) .The work load including basic medical care and basic public health services they committed were approximately matching .The top 5 items of basic medical care were ,in proper sequence ,diagnoses and treatments of common diseases ,common symptoms ,chronic disease management ,communi‐ty rehabilitation ,community first aid .The top 5 items of basic public health services were establishment of residents′health files , maternal and child health ,health care of the aged ,immunization ,health education .Conclusion The technological levels of diagnosis and treatment and theoretical knowledge of rural doctors should be further improved .The clinical medical education of junior medi‐cal colleges must strengthen the training and cultivation of the students′abilities of basic public health services ,besides consolida‐ting the training of the abilities of practical diagnosis and treatment .
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Objectives: To investigate the current state of pension security for rural doctors in 12 provinces those have not introduced related policies. Methods:Two counties were chosen in each province. Data was analyzed in terms of coverage, types and intention of pension security for rural doctors in these areas. Results:The study found that the proportion of rural doctors with pension security was 81. 4% in these areas. 57. 1% of rural doctors with pen-sion security had urban and rural pension insurance. Differences exist among these areas. The safeguard level is too low, and the willingness of rural doctors to attend to pension security is not strong enough. Results:The mechanism of pension security for rural doctors must be improved. These areas should implement classified guidance and syn-chronize various models to solve the problem of pension security for rural doctors.
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This practice of villagers' autonomy in township governance has transformed the income model of rural doctors,desalinated the nature of public welfare of village clinics,weakened the occupational attractions of rural doctors,softened the once strict assessment on rural doctors previously conducted by health authorities,and affected the selection of rural doctors in their place of practice.These setbacks discourage professionals in becoming rural doctors,and discourage their incentive to be competent.Outcomes of such a practice include shrinkage medical and health services provided in different degrees,poor distribution of rural doctors in overlapping,shifts or blank,all these affecting the equity and accessibility of the rural residents' access to basic medical and health services,and the construction of rural harmonious doctor-patient relationship.
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Objective To learn the professional ability of rural doctors in our country ,to provide scientific reference for educa-tional reform of junior-college clinical medicine .Methods A self-made questionnaire was performed in 1 245 rural doctors from 86 rural grassroots health institutions in 7 provinces(municipalities) of our country .Results The rural doctors were familiar with working environment ,coordinated and communicated well with colleagues ,basic competence at work .But their clinical diagnosis-treatment technology and operational capability of medical equipments were not strong .The doctor-patient relationship was not so good .Conclusion Not the proper use of medical equipment and treatment technology of weak seriously affected the quality of serv-ice .Not ideal doctor-patient relationship influenced the service effect .It was suggested that college of clinical medical professional education should enhance the cultivation of students′clinical diagnosis technology ,basic operational skills and communication skills between doctors and patients .
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Conduction of institutionalized and standardized education for nnal doctors is one of the specific measures that can be taken to put into effect the gist of the documents issued by the State Council, realize healthcare for all people in the rural areas of China by the year 2000, and improve the quality of medical services in the rural areas. The steps taken by Yun County include: ①strengthening leadership so as to guarantee the smooth conduction of the work; ②establishing training bases so as to provide the necessary environment; ③working out policies so as to create the right circumstances; and ④consolidating measures so as to bring into play the initiative of nual doctons in participating in the education. As a result of the above steps, health stations have been set up in all the 396 administrative villages throughout the county, with the average number af rural doctors in each village being 1.47. 86.1% of these rural doctors have participated in the education, with the newly employed 29 rural doctors all having received technical secondary education in health. Yet the construction of the contingent of rural doctors is still confronted with some problems needing prompt solution.
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conduction of institutionalized and stanardized education for rural doctors is one of the specific measures that can be taken to put into effectt the gist of the documents issued by the State Council, realize healthcare for all people in the rural areas of China by the year 2000, and imprvove the quality of medical services in the rural areas. The steps taken by Yun County include: ①strengthening leadership so as to guarantee the smooth conduction of the work; ②establishing training hases so as to provide the necessary environment; ③working out policies so as to create the right circumstances; and ④consolidating measures so as to bring into ply the ndhative of rural doctors in participating in the education. As a result of the above steps, health stations have ho set up in all the 396 administrative villages throughout the county, with the average number of rural doctors in each village being 1.47. 86. 1% of these rural doctors have participated in the education, with the newly employed 29 ed doctors all having received technical secondary education in health. Yet the construchon of the contingent of ed doctors is still confronted with some problems needing prompt solution.
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Objective To find out about rural doctors' knowledge on the basic facts about AIDS and the spread of HIV via illegal blood collection and supply and explore viable intervention methods in AIDS prevention and treatment in rural areas. Methods All the rural doctors in a certain township where the epidemic of HTV being spread via blood collection and supply was pretty serious were selected for the survey and data were collected by combining qualitative and quantitative studies. Results The survey of 33 doctors was effective( 100% ) ; above 95% had a correct understanding of the spread of AIDS through sex and blood as well as its contagiousness; 50% did not possess the knowledge that HIV could be spread to the baby by the mother but could not be spread through saliva, sweat, mosquito bites or sharing of bathtubs or toilets; above 80% knew about the objective of the blood organizers in their villages, the peak time of blood selling by the villagers, and the risks of diseases being spread via blood, and were opposed to blood selling; 27.3% once in a while used disposable syringes, and 15.2% discarded or sold used disposable syringes. Conclusion There are severe lurking perils of iatrogenic cross infection in rural areas. Rural doctors are in dire need of formal training in AIDS prevention and treatment knowledge and could be expected to become the key force in AIDS prevention and treatment in rural areas.