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Objective:To survey the status quo of clinical teaching by specialists in general practice residents training.Methods:Thirty-four general practice residents (14 males and 20 females, aged (27.9±1.8) years) who started standardized training in 2016, 2017 and 2019 in the First Affiliated Hospital of Zhejiang University School of Medicine were selected for interview. The semi-structured and open-ended telephone interviews were conducted 6 months after their completion of residency training. The 1st round of interviews with 12 residents of 2016 and 2017 batches was conducted in March 2020 and 2021 to understand their feelings and suggestions about specialty learning. Based on the interview results, literature review, expert consultation and internal discussion, a new model for specialty teaching was developed and applied for subsequent residency training. The second round of interviews was conducted with 22 residents of 2019 batch on March 2023 to investigate the implementation of the new model.Results:In the first round of interviews, 6 participants felt that the learning of specialty knowledge was not comprehensive enough; although all respondents said that they had received simulator training for the final exam in the specialty rotation, 2 people felt that it was not comprehensive and 2 mentioned that some of the items were not practised on a real person; all 12 respondents felt that there was a certain gap between the types of diseases they encountered in the specialty learning and the real world of work; 10 respondents mentioned that there was insufficient training in the management of chronic non-chronic diseases; 7 out of 9 respondents from primary care institutions mentioned that it was difficult to apply the learned specialty knowledge to real work due to local conditions; 7 respondents mentioned that the content and methods of teaching were inconsistent among different lecturers; and respondents hoped that the surgical training, physical exam training, medication instruction, and the length of outpatient follow-up consultations would be strengthened. In the second round of interviews, the feedback of respondents was more positive than in the first round, there were still problems with the separation of teaching and examination content, and insufficient practical training of skills; 2 respondents from general hospitals mentioned that the teaching of specialties should be further deepened, and 3 respondents from the primary care institutions mentioned that the teaching of treatment and follow-up management should be further strengthened. Twenty-one respondents generally accepted the new specialty teaching model, but said that there were big differences between teachers of different specialties and there were still problems such as insufficient guidance on drug treatment and follow-up.Conclusion:In general practice, residency training specialist teaching does not fully meet the requirements of the actual work of general practitioners, and although it has improved after optimization, there is still much room for improvement.
RESUMO
Objective:To construct the core competence evaluation index system of general practice residents by the Delphi method.Methods:After the literature review of home and abroad and group discussion, the core competence evaluation index system of general practice residents in the outpatient environment was preliminarily developed. On this basis, the index system was determined through two rounds of expert consultation. Excel 2015 and SPSS 26.0 were used for data entry and statistical analysis.Results:The active coefficients of the two rounds of expert consultation were 95.0% (19/20) and 100.0% (19/19) respectively, and the degree of authority of the two rounds of expert consultation was 0.86. An index system consisting of 6 first-level indicators and 28 second-level indicators was determined. The 6 first-level indicators were medical services/patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, interpersonal communication, and communication skills.Conclusion:This study has constructed a complete and highly reliable core competence evaluation index system of general practice residents based on the outpatient environment, which can provide reference for the cultivation of the outpatient reception ability of general practice residents in the future.
RESUMO
Objective To understand the epidemiological characteristics of acute respiratory virus infection in hospitalized patients, and to provide reference for clinical diagnosis and treatment, and to develop relevant intervention measures. Methods A total of 414 hospitalized patients with respiratory virus infection admitted to our hospital from March 2019 to March 2021 were selected. Immunofluorescence method was used to qualitative detect parainfluenza virus type 1-3, influenza A virus, respiratory syncytial virus (RSV), influenza B virus and adenovirus. Results Among the 414 ARTI patients, 84 cases were positive for respiratory virus, with a positive detection rate of 20.29% (84/414 ) . 76 cases were positive for single virus infection, with a positive detection rate of 18.36% (76/414) . The positive detection rate was 1.93% (8/414). The most common pathogens of virus infection were influenza A virus (25.00%), influenza B virus (20.23%) and RSV(17.86%). There was statistical significance in the positive rate of ARTI among different age groups (χ2, P2, P0.05). The positive rate of PIV3 was the highest in spring (4.04%), and the positive rate of RSV in spring and winter was 24.24% and 25.20%, respectively. The positive rates of influenza A virus and influenza B virus were the highest in winter (9.45%) and (7.09%). There was statistical significance in the positive rate of ARTI among different clinical diagnoses (χ2, P<0.05). The positive rates of PIV2, PIV3, influenza A virus and influenza B virus were significantly different (P<0.05). The positive rate of bronchopneumonia virus was the highest (27.48%). Conclusion: RSV infection is the most common in patients with acute respiratory virus infection in Chengdu area, which mostly occurs in autumn and winter, and the main clinical manifestation is bronchopneumonia. The main infected population is children under 8 years old, and the surveillance of respiratory syncytial virus should be strengthened in the future.