Survey on clinical teaching by specialists in general practice residency training / 中华全科医师杂志

ABSTRACT

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.