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