基于扎根理论探讨全科医生专长化培训方案的优化  

Exploration the optimization of the special interests training program for general practitioners based on grounded theory

作　　者：孟佳[1] 郭萌 王君颖[1] 姜礼红[1] MENG Jia;GUO Meng;WANG Junying;JIANG Lihong(General Practice,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院全科医疗科,黑龙江哈尔滨150086

出　　处：《中华全科医学》2023年第7期1224-1228,共5页Chinese Journal of General Practice

基　　金：全国医学专业学位研究生教育指导委员会全科医学教育教学研究课题(B-YXGP20210201-04);黑龙江省教育科学“十四五”规划2022年度重点课题(GJB1422775)。

摘　　要：目的通过扎根理论视角,全面探索全科医生专长化培训方案的影响因素,为专长化培训方案的优化实施提供实证支持。方法对哈尔滨医科大学附属第二医院全科住培基地已完成专长化培训的14名学员进行半结构式访谈,基于程序化扎根理论研究方法,对访谈原始资料进行开放式编码、轴心式编码和选择式编码,最终构建相关理论模型。结果在开放式编码过程中,形成171个编码号、17个初始概念及6个范畴;通过轴心式编码总结出3个主范畴;最终选择式编码得出“全科医生专长化培养方案优化”这一核心范畴,并从3个维度进行理论模型构建。结论增强全科医生专长化培养的内向驱动力,满足其“全”加“专”综合素质提升的刚性需求,并注重培训过程中的兴趣驱动元素,为方案的优化实施提供坚实基础;形成以专科带教教师为主导、全科教师为桥梁、各部门积极配合的协同管理模式,同时制定严格的考核管理标准,为确保专长化培训方案的高效实施提供有力的保障;不断提高带教教师的带教意识,注重师资遴选及人员配置,使教学水平逐步提升是方案优化实施的核心因素。Objective To comprehensively explore the factors influencing the special interests training program for general practitioners from a grounded theory perspective,and to provide empirical support for optimizing the implementation of the special interests training program.Methods The semi-structured interviews were conducted with 14 students who had completed the special interests training program at the standardized training base for general practice residents of the Second Affiliated Hospital of Harbin Medical University,Based on the procedural grounded theory research method,the open coding,axial coding,and selective coding were conducted on the raw interview data,and the relevant theoretical model was finally constructed.Results In the open coding process,171 coding numbers,17 initial concepts and 6 categories were formed.Three primary categories were summarized by axial coding.The final selection coding resulted in the core category"the optimization of the special interests training program for general practitioners"and the theoretical model was constructed from three dimensions.Conclusion To enhance the internal driving force of special interest straining of general practitioners,to meet the rigid demand for comprehensive quality improvement of"full"and"specialisation",and to focus on the interest-driven elements in the training process,so as to provide a solid foundation for optimizing the implementation of the program.A collaborative management mode should be established with specialized teachers as the leaders,general practice teachers as the bridge,and active cooperation from all departments.Strict assessment criteria should be formulated so as to provide a strong guarantee for the efficient implementation of the special interests training program.The core factors for the implementation of the program optimization are to constantly improve the teaching consciousness of teachers,pay attention to the selection of teachers and staff,and gradually improve the teaching level.

关 键 词：全科医生 专长化 半结构访谈 扎根理论 质性研究 

分 类 号：R192.3[医药卫生—卫生事业管理] R499[医药卫生—公共卫生与预防医学]