1
|
Xin R, Li L, Qiaoli S, Xingyue W, Shuangqing L. Perspectives of general practitioners towards their supervisors over the past ten years in China. BMC MEDICAL EDUCATION 2022; 22:415. [PMID: 35641981 PMCID: PMC9158279 DOI: 10.1186/s12909-022-03442-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/27/2022] [Indexed: 02/08/2023]
Abstract
Objectives Doctors who wish to become general practitioners (GPs) in China are required to attend and complete general practice resident training. In the early stages of the standardized GP training system, GP training supervisors play important roles. This study aims to explore how GP residents perceive their GP supervisors, factors that affect GP residents’ satisfaction level, as well as to offer suggestions based on the implications of this study. Design We conducted a mixed quantitative and qualitative study. Firstly, with respect to the quantitative research, we conducted a survey to investigate training satisfaction through questionnaires, then extracted and analyzed the factors that influence training satisfaction. In the qualitative study, we conducted in-depth, semistructured interviews using qualitative research criteria (COREQ)––a 32-item checklist for interviews. Participants Participants in the quantitative survey included 1172 GPs whose training time wasbetween 2008 and 2017. Afterwards, 100 participants were selected from this sample , filtered by stratified random sampling and by having provided extreme answers on the quantitative survey (less than 5% of the total sample). They were chosen for the qualitative research to conduct a more detailed investigation., This stratified random sampling was based on residents’ grades, regions, and training levels (city level or county level). Extreme answers were identified as answers of “extremely good” or “extremely bad” to questions from the initial comprehensive survey of 1172 participants. Consequently, 30 participants with extreme answers were found, while the remaining 70 participants in the interviews were selected by stratified random sampling. Ultimately, this sample of participants met our information collection and sample estimation requirements. Results The results show that satisfaction with GP theoretical training supervisors, GP hospital-based training supervisors, and GP community-based training supervisors differed. Considering long-term averages, the hierarchy of satisfaction is as follows: GP theoretical training supervisors > GP community-based training supervisors > GP hospital-based training supervisors. GP hospital-based training supervisors need to improve their conception of GPs, teaching methods and conscientiousness. GP community-based training supervisors need to improve their teaching methods, knowledge of clinical theory and practice ability. Conclusions On the one hand, teams of GP supervisors in China have gradually been established over time. On the other hand,the satisfaction tendencies of residents with respect to their GP supervisors are quite different, and teams of GP supervisors must be promoted and improved. Supplementary Information The online version contains supplementary material available at 10.1186/s12909-022-03442-3.
Collapse
Affiliation(s)
- Rao Xin
- Department of General practice, West China Hospital, SCU, Chengdu, China.,Institute of Hospital Management, West China Hospital, SCU, Chengdu, China
| | - Luo Li
- Institute of Service Management, School of business, SCU, Chengdu, China
| | - Su Qiaoli
- Department of General practice, West China Hospital, SCU, Chengdu, China.
| | - Wang Xingyue
- Department of Graduate medical education, West China Hospital/School of Medcine, SCU, Chengdu, China
| | - Li Shuangqing
- Department of General practice, West China Hospital, SCU, Chengdu, China
| |
Collapse
|
2
|
Wang YE, Zhang C, Chen AC, Pineles S, Hou J. Current Status of Ophthalmology Residency Training in China: The Experience From Well-Structured Centers Around the Country. Asia Pac J Ophthalmol (Phila) 2020; 9:369-373. [PMID: 32501893 DOI: 10.1097/apo.0000000000000284] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Chinese ophthalmology residency training is continuously evolving with an emphasis on standardization. In this article, we assess the current status of ophthalmology residency training in China compared with that in the United States through analysis of literature review and onsite data collection. We comprehensively review various aspects of the residency training structure in China, including accreditation, resident selection, clinical and surgical curricula, research requirements, and evaluation. Our report demonstrates significant regional differences among training programs due to the lack of a national standard, resulting in varying competencies of graduating Chinese ophthalmology residents. The Chinese ophthalmology community is determined to improve the standardization process and quality of training for their ophthalmologists, an important goal that will facilitate international fellowship studies, exchange scholars, and research collaboration.
Collapse
Affiliation(s)
- Ye Elaine Wang
- Stein Eye Institute, UCLA Department of Ophthalmology, Los Angeles, CA
- Bascom Palmer Eye Institute, University of Miami, Coral Gables, FL
- Harvard Eye Associates, Laguna Hills, CA
| | - Chuan Zhang
- Department of Ophthalmology, People's Hospital, Peking University, Beijing, China
| | | | - Stacy Pineles
- Stein Eye Institute, UCLA Department of Ophthalmology, Los Angeles, CA
- UCLA GSM
| | - Jing Hou
- Department of Ophthalmology, People's Hospital, Peking University, Beijing, China
| |
Collapse
|
3
|
Hou J, He Y, Zhao X, Thai J, Fan M, Feng Y, Huang L. The effects of job satisfaction and psychological resilience on job performance among residents of the standardized residency training: a nationwide study in China. PSYCHOL HEALTH MED 2020; 25:1106-1118. [PMID: 31992067 DOI: 10.1080/13548506.2019.1709652] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
High resident job performance is essential for effective medical professionalism. To date, few studies have investigated the potential predictors of job performance among residents in standardized residency training (SRT) program in China. Therefore, a nationwide survey among Chinese residents in SRT program was conducted to evaluate the impact of job satisfaction and psychological resilience on job performance. A total of 1146 residents from 9 hospitals were recruited in this study. Demographic and work-related information, job satisfaction, psychological resilience and job performance were collected through questionnaires. Hierarchical regression analyses indicated that, "work pressure", "doctor-patient conflict", "intrinsic job satisfaction" and "psychological resilience" were significant predictors of job performance for residents in SRT programs and explained 61.3% of variance, while the three dimensions of psychological resilience (tenacity, strength and optimism) accounted for 27.2% of variance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve showed that resilience had the highest predictive accuracy than another three subscales. This study indicated that intrinsic job satisfaction and psychological resilience had a significant influence on job performance. Strategies and measures to improve residents' intrinsic job satisfaction and psychological resilience may be efficacious ways to enhance their job performance.
Collapse
Affiliation(s)
- Jiaojiao Hou
- Medical Education Division & Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine , Shanghai, China.,Shanghai East Hospital affiliated Tongji University School of Medicine , Shanghai, China
| | - Yifei He
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg , Marburg, Germany.,Department of Translation Studies, Linguistics and Cultural Studies, Johannes Gutenberg University Mainz , Mainz, Germany
| | - Xudong Zhao
- Shanghai East Hospital affiliated Tongji University School of Medicine , Shanghai, China.,Pudong New Area Mental Health Center , Shanghai, China
| | - Jessica Thai
- College of Medicine, University of Nebraska Medical Center , Omaha, NE, USA
| | - Mingxiang Fan
- Tong ji University School of Medicine , Shanghai, China
| | | | - Lei Huang
- Medical Education Division & Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine , Shanghai, China
| |
Collapse
|
4
|
He Y, Qian W, Shi L, Zhang K, Huang J. Standardized residency training: An equalizer for residents at different hospitals in Shanghai, China? Int J Health Plann Manage 2019; 35:592-605. [PMID: 31742772 DOI: 10.1002/hpm.2970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/31/2019] [Accepted: 11/04/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The residency training programme in Shanghai is the first in China to become standardized; however, there has been no evidence that the programme equalizes training quality. This cross-sectional study examined whether residents in all disciplines at different hospitals perceived equivalent improvement in professional competency after this programme. METHODS We recruited all 2283 residents who enrolled in the programme in 2013. Before graduation, the residents reported their perceived competency improvement as the primary outcome and their hospital of residency, awareness of the programme's requirements and policies, and demographic information as explanatory variables. We ran multivariate linear regressions and mixed-effect multilevel regression to examine whether the hospital type and the university affiliation were associated with perceived improvement. RESULTS A total of 2208 residents completed the survey. Although the adjusted multilevel regression analysis showed that the improvement scores at tertiary specialty hospitals and tertiary general hospitals were lower than those at secondary general hospitals, the difference was not statistically significant. No variance in improvement scores could be explained by the hospital type or university affiliation. CONCLUSION Receiving residency training at hospitals that were traditionally less resourced did not compromise educational quality based on the perception of the residents.
Collapse
Affiliation(s)
- Yao He
- Key Lab of Health Technology Assessment, National Health Commission, School of Public Health, Fudan University, Shanghai, China
| | - Wenji Qian
- Key Lab of Health Technology Assessment, National Health Commission, School of Public Health, Fudan University, Shanghai, China.,Administrative Office, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lu Shi
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina, USA
| | - Kan Zhang
- Department of Science and Education, Shanghai Health Commission, Shanghai, China
| | - Jiayan Huang
- Key Lab of Health Technology Assessment, National Health Commission, School of Public Health, Fudan University, Shanghai, China
| |
Collapse
|
5
|
Yang Z, Liao J, Li J. Quantity or quality? Implications for postgraduate medical training system in China. QJM 2014; 107:169-70. [PMID: 24336847 DOI: 10.1093/qjmed/hct250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
6
|
|
7
|
Oman K, Rodgers E, Usher K, Moulds R. Scaling up specialist training in developing countries: lessons learned from the first 12 years of regional postgraduate training in Fiji - a case study. HUMAN RESOURCES FOR HEALTH 2012; 10:48. [PMID: 23270525 PMCID: PMC3543231 DOI: 10.1186/1478-4491-10-48] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 12/05/2012] [Indexed: 06/01/2023]
Abstract
UNLABELLED BACKGROUND In 1997, regional specialist training was established in Fiji, consisting of one-year Postgraduate Diplomas followed by three-year master's degree programs in anesthesia, internal medicine, obstetrics/gynecology, pediatrics and surgery. The evolution of these programs during the first 12 years is presented. CASE DESCRIPTION A case study utilizing mixed methods was carried out, including a prospective collection of enrolment and employment data, supplemented by semi-structured interviews. Between 1997 and 2009, 207 doctors (113 from Fiji and 94 from 13 other countries or territories in the Pacific) trained to at least the Postgraduate Diploma level. For Fiji graduates, 29.2% migrated permanently to developed countries, compared to only 8.5% for regional graduates (P <0.001). Early years of the program were characterized by large intakes and enthusiasm, but also uncertainty. Many resignations took place following a coup d'etat in 2000. By 2005, interviews suggested a dynamic of political instability initially leading to resignations, leading to even heavier workloads, compounded by academic studies that seemed unlikely to lead to career benefit. This was associated with loss of hope and downward spirals of further resignations. After 2006, however, Master's graduates generally returned from overseas placements, had variable success in career progression, and were able to engage in limited private practice. Enrolments and retention stabilized and increased. DISCUSSION AND EVALUATION Over time, all specialties have had years when the viability and future of the programs were in question, but all have recovered to varying degrees, and the programs continue to evolve and strengthen. Prospective clarification of expected career outcomes for graduates, establishment of career pathways for diploma-only graduates, and balancing desires for academic excellence with workloads that trainees were able to bear may have lessened ongoing losses of trainees and graduates. CONCLUSIONS Despite early losses of trainees, the establishment of regional postgraduate training in Fiji is having an increasingly positive impact on the specialist workforce in the Pacific. With forethought, many of the difficulties we encountered may have been avoidable. Our experiences may help others who are establishing or expanding postgraduate training in developing countries to optimize the benefit of postgraduate training on their national and regional workforces.
Collapse
Affiliation(s)
- Kimberly Oman
- Consultant Infectious Diseases Physician, The Townsville Hospital, 100 Angus Smith Drive, Townsville, QLD 4814, Australia
| | - Elizabeth Rodgers
- Head of the Department of Medical Sciences, College of Medicine, Nursing and Health Sciences, Fiji School of Medicine, Fiji National University, Private mail bag, Suva, Fiji
| | - Kim Usher
- Discipline of Nursing, Midwifery and Nutrition, James Cook University, Cairns Campus, PO Box 6811, Cairns, QLD 4870, Australia
| | - Robert Moulds
- Medical Advisor to Therapeutic Guidelines, Therapeutic Guidelines Limited, 473 Victoria St, West Melbourne, VIC 3003, Australia
| |
Collapse
|
8
|
Zhang Y, Qu B, Lun SS, Guo Y, Liu J. The 36-item short form health survey: reliability and validity in Chinese medical students. Int J Med Sci 2012; 9:521-6. [PMID: 22991490 PMCID: PMC3444972 DOI: 10.7150/ijms.4503] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 08/19/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The 36-Item Short Form Health Survey (SF-36) is widely validated and popularly used in assessing the subjective quality of life (QOL) of patients and the general public. The aim of the study is to assess the psychometric properties of the 36-Item Short Form Health Survey (SF-36) in medical students in mainland of China. METHODS The reliability and validity of the 36-Item Short Form Health Survey (SF-36) questionnaire were assessed by conducting a cross-sectional study of Chinese medical students in December 2011. All 1358 3(rd) year and 4(th) year medical students from 46 classes at China Medical University were investigated. RESULTS The overall Cronbach's α coefficient of the SF-36 questionnaire was 0.791, while the respective Cronbach's α coefficients for each of the seven dimensions were > 0.70, except where the social function dimension was 0.631. Results showed that the SF-36 questionnaire was reliable and valid. CONCLUSION In general, this study provides evidence that the SF-36 questionnaire is suitable measures for assess the QOL of medical students in China.
Collapse
Affiliation(s)
- Yang Zhang
- The Research Centre for Medical Education, China Medical University, 92 North Second Road, Heping District, Shenyang 110001, China
| | | | | | | | | |
Collapse
|