Email Alert | RSS    帮助

中国防痨杂志 ›› 2019, Vol. 41 ›› Issue (7): 719-726.doi: 10.3969/j.issn.1000-6621.2019.07.004

• 论著 • 上一篇    下一篇

结核病相关医疗机构医师受教育及在职学习满意度状况调查

周爽,张瑞,陈效友,阚晓宏,彭鹏,杜建()   

  1. 101149 首都医科大学附属北京胸科医院 北京市结核病胸部肿瘤研究所(周爽、张瑞、陈效友、杜建);安徽省胸科医院科教科(阚晓宏);武汉市肺科医院 武汉市结核病防治所(彭鹏)
  • 收稿日期:2019-03-29 出版日期:2019-07-10 发布日期:2019-07-09
  • 通信作者: 杜建 E-mail:jdu-sdu@163.com
  • 基金资助:
    首都医科大学附属北京胸科医院“212”人才工程项目(212-20180405)

Investigation and evaluation on educational condition and further training situation of physicians in tuberculosis control and treatment institutions

Shuang ZHOU,Rui ZHANG,Xiao-you CHEN,Xiao-hong KAN,Peng PENG,Jian DU()   

  1. Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
  • Received:2019-03-29 Online:2019-07-10 Published:2019-07-09
  • Contact: Jian DU E-mail:jdu-sdu@163.com

摘要:

目的 了解我国结核病相关医疗机构医师的受教育情况,比较单位和医师个人之间对于医师在职学习的认知和期望,分析限制医师参加学习深造的因素,为医疗机构创造更好的医师培养环境提供建议。方法 于2018年10—12月,选取全国结核病医院联盟中41家结核病相关的医疗机构(包括综合性医院、专科医院及结核病防治机构)作为调查对象。设计两份问卷,分别针对医疗机构的教育主管人员和结核科医师进行问卷调查,调查内容包括单位基本情况、对医师受教育情况的满意度、单位的医师培养措施等。医疗机构层面调查共回收有效问卷41份,问卷有效率100.0%(41/41);结核科医师层面调查共回收有效问卷194份,问卷有效率100.0%(194/194)。比较单位和医师个人对于医师在职学习的倾向性、认知和期望情况。结果 12.2%(5/41)的医疗机构对医师的学历结构满意,在认为“研究生以上学历人员数量不足”的单位中,有70.8%(17/24)的单位招收医师的条件低于研究生水平。不同学历结核科医师对于本人学历层次的满意度差异有统计学意义(χ 2=29.21,P=0.001),本科学历人员的满意度为10.4%(14/134),研究生学历人员的满意度为22.0%(11/50),专科学历人员的满意度为20.0%(2/10)。90.2%(37/41)的医疗机构采取了一定的人才培养措施,75.6%(31/41)的单位可全额报销学历深造的学费,43.9%(18/41)的单位表示存在经费紧张的问题。对于脱产学习时长的倾向性单位与医师个人之间差异有统计学意义(χ 2=27.40,P<0.01):85.4%(35/41)的单位倾向于支持36个月的脱产学习,而46.4%(90/194)的医师更倾向于参加12年的脱产学习。78.0%(32/41)的单位和70.6%(137/194)的医师都认为“科室人员紧缺”是影响在职人员学习深造的主要因素,“个人学习意愿不强”[34.2%(14/41)]和“学习占用时间较长”[53.1%(103/194)]分别为两者选择的次要因素,另有34.2%(14/41)的单位和46.4%(90/194)的个人选择了“资金支持不足”。促进医师参加学习深造的措施,单位和个人对于“创造丰富多样的学习机会”的期望值均最高,分别占90.2%(37/41)和76.3%(148/194)。结论 我国结核病相关医疗机构的医师受教育情况不理想,单位和医师之间对于在职学习的认知和期望存在差异。医疗机构需要贴合医师需求,支持医师学习深造,以创造更好的人才培养环境。

关键词: 结核, 卫生系统机构, 医务人员, 教育,继续, 问卷调查, 数据说明,统计

Abstract:

Objective This study aimed to investigate the educational condition of physicians in tuberculosis (TB) control and treatment institutions in China, compare the recognition and expectation of further training between institutions and physicians, and analyze the factors restricting physicians from pursuing further education, which might provide several suggestions for medical institutions to create a better training environment for physicians. Methods From October to December 2018, 41 TB-related medical institutions (including general hospitals, specialized hospitals and tuberculosis prevention and control institutions) were selected as the subjects of this survey on the platform of the National Tuberculosis Hospital Alliance (hereinafter referred to as the “Alliance”). Two questionnaires were, respectively, designed to conduct questionnaire surveys for medical administrators and TB physicians, including the basic information of the institutions, satisfaction with the educational condition of physicians, and support measures for physician training, etc. A total of 41 valid questionnaires (effectiveness 100.0%, 41/41) for medical institutions and 194 valid questionnaires (effectiveness 100%, 194/194) for TB physicians were retrieved, repectively. Then the tendency, recognitions and expectations were compared between institutions and physicians. Results A total of 12.2% (5/41) of medical institutions were satisfied with the doctor’s educational background structure; and 70.8% (17/24) of the institutions with “shortage in number of postgraduates or above” still kept lower recruitment conditions than postgraduates. A significant difference was found in the satisfaction degree of TB physicians with different educational levels (χ 2=29.21, P=0.001), and the satisfaction degree of undergraduate physicians was 10.4% (14/134), with postgraduate degree was 22.0% (11/50), and with associate degree was 20.0% (2/10). There were 90.2% (37/41) of medical institutions which adopted some talent cultivation measures, 75.6% (31/41) of the institutions could fully reimburse the tuition fees, and 43.9% (18/41) of the institutions had some difficulties in funding support. There was a significant difference between institutions and physicians in the tendency to the length of off-job learning (χ 2=27.40, P<0.01), and 85.4% (35/41) of institutions preferred a 3 to 6 months-long learning, while 46.4% (90/194) of individuals preferred 1 to 2 years. Totally, 78.0% (32/41) of the institutions and 70.6% (137/194) of the physicians believed that “department staff shortage” was the main factor influencing the participation of physicians’ training, while “weaker individual learning willingness” (34.2% (14/41)) and “longer learning time” (53.1% (103/194)) were secondary factors for the institutions and physicians, respectively. In addition, 34.2% (14/41) of the institutions and 46.4% (90/194) of the physicians chose “financial support insufficiency”. Among the support measures for physician training, the institutions and physicians were most looking forward to “creating rich and varied learning opportunities”, accounting for 90.2% (37/41) and 76.3% (148/194). Conclusion The educational situation of physicians in TB control and treatment institutions is unsatisfactory in China, and there were certain differences in the recognitions and expectations of further training between institutions and physicians. In order to create a better training environment for physicians, TB control and treatment institutions need to meet the demands of physicians and support their further training.

Key words: Tuberculosis, Health systems agencies, Medical staff, Education,continuing, Questionnaires, Data interpretation,statistical