海南省农村订单定向医学毕业生基层工作情况及职业规划调查研究  

Working Status in Primary Care and Career Planning in Targeted Admission Medical Graduates:a Study from Hainan Province

作　　者：林芸芸[1,2] 黄珊珊 宋艳玲[1,2] 张云波 刘学军 顾申红[1,2] LIN Yunyun;HUANG Shanshan;SONG Yanling;ZHANG Yunbo;LIU Xuejun;GU Shenhong(College of General Practice and Continuing Education,Hainan Medical University,Haikou 570102,China;Department of General Practice,the First Affiliated Hospital of Hainan Medical University,Haikou 570000,China;Department of General Practice,Wanning Dong'ao Town Health Center,Wanning 571528,China;Primary Health Department of Hainan Provincial Health Commission,Haikou 570000,China)

机构地区：[1]海南医学院全科医学与继续教育学院,海南省海口市570102 [2]海南医学院第一附属医院全科医学科,海南省海口市570000 [3]海南省万宁市东澳镇中心卫生院全科医学科,571528 [4]海南省卫生健康委员会基层卫生健康处,海南省海口市570000

出　　处：《中国全科医学》2023年第4期494-503,共10页Chinese General Practice

基　　金：2022年海南省高等学校教育教学改革研究重点项目课题(Hnjg2022ZD-30);2021年海南医学院教育科研重点课题(HYZD202108);2021年度海南省卫生健康行业科研项目课题(21A200086);2022年海南医学院教学成果奖培育项目(HYjcpx202212);2022年度海南省高等学校教育教学改革研究一般项目(Hnjg2022-69);2021年海南医学院教育科研一般课题(HYYB202104)。

摘　　要：背景我国从2010年开始开展农村订单定向医学生免费培养工作,为基层医疗卫生机构培养从事全科医疗的卫生人才。农村订单定向医学毕业生在基层的工作情况和职业规划,以及基层用人单位对其各方面的评价情况,都需要进一步的研究。目的全面了解海南省正在履约的经“5+3”模式培养的农村订单定向医学毕业生(简称“5+3”订单定向全科医生)在基层的工作情况(包括服务能力、岗位满意度、专业能力提升意愿等)及其职业规划状况,探讨其履约期满后留任的意愿及其影响因素,旨在为今后调整优化全科医生培养与使用激励政策提供依据,为医学院校确立全科医学院(系)的定位与发展方向提供参考。方法于2021-04-25至2021-05-06,采用整群抽样法,选取海南省19个市(县)的“5+3”订单定向全科医生309例及其所在单位的经“3+2”模式培养的助理全科医生56例、转岗全科医生250例为研究对象,采用自设问卷对其进行调查,邀请其对服务能力进行自我评价,了解其对岗位的满意度及专业能力提升意愿。同时邀请“5+3”订单定向全科医生所在单位的管理者及其他医务工作者共1574例对其服务能力进行评价。采用二分类Logistic回归分析“5+3”订单定向全科医生履约期满后留任意愿的影响因素。于2021年5月7—8日,分别从海口市、琼中县、三亚市选取1家基层医疗卫生机构,线下调研组到3家基层医疗卫生机构开展实地调研并召开专题座谈会,邀请市(县)卫生健康委员会相关负责人、基层医疗卫生机构主要负责人,以及随机抽取的38例“5+3”订单定向全科医生共同参与座谈会,了解“5+3”订单定向全科医生的工作、生活和思想等方面的情况,听取有关方面的意见与建议。结果309例“5+3”订单定向全科医生自评服务能力总得分为(19.31±2.59)分,低于经“3+2”模式培养的助理全科医生〔(20Background The program of targeted medical education program has been carried out since 2010 in China,aiming to train general medical talents working in primary care.Further research is needed to explore the working status and career planning in targeted admission medical graduates(TAMG),as well as the overall assessment for them by the employing unit.Objective To comprehensively understand the working status(competencies,satisfaction,intention to improve professional capabilities),career planning,retention intention and associated factors after fulfilling the preadmission commitments in TAMG working in Hainan's primary care after completing the"5+3"standardized general residency program,providing a basis for the optimization of incentive policies for training and retaining general practitioners(GPs),and for medical colleges to determine the orientation and development direction of a general practice school(department).Methods From April 25 to May 6,2021,by use of cluster sampling,615 GPs(including 309 TAMG trained with the"5+3"standardized general residency program who work as a GP in primary care after graduation,56 assistant GPs trained with the"3+2"program,and 250 GPs trained with general medicine before shifting to the post)were selected from 19 cities(counties)in Hainan Province to attend a self-administered questionnaire survey for collecting information about their capabilities,satisfaction and intention to improve professional capabilities.At the same time,1574 leaders and colleagues of the TAMG were invited to evaluate the capabilities of the TAMG.The factors influencing the retention intention of the TAMG after fulfilling their preadmission commitments in primary care were analyzed by binary Logistic regression.For further understanding the working status,life and thoughts on the job of the TAMG,the offline research team of this study conducted field investigation in three primary hospitals(one in Haikou,one in Qiongzhong,and one in Sanya),and held a group discussion with directors of health committees

关 键 词：全科医生 农村订单定向医学毕业生 基层服务意愿 职业规划 教育 医学 卫生政策 卫生人力 初级卫生保健 海南 

分 类 号：R192[医药卫生—卫生事业管理] R197.1[医药卫生—公共卫生与预防医学]