政策工具对北京市乡村两级继续医学教育的影响分析

doi:10.3760/cma.j.issn.1673-677X.2018.01.026

中华医学教育杂志 ›› 2018, Vol. 38 ›› Issue (1): 113-118.DOI: 10.3760/cma.j.issn.1673-677X.2018.01.026

政策工具对北京市乡村两级继续医学教育的影响分析

董屹, 王晨, 李娜, 姜悦, 马力, 刘兰秋, 彭迎春, 贾东梅, 齐韶涵

100050 首都医科大学附属北京天坛医院院办公室(董屹、李娜),全科医学科(王晨、马力),医务处(姜悦); 100069 北京,首都医科大学卫生管理与教育学院卫生法学系(刘兰秋),医学人文学系(彭迎春),2015级社会医学与卫生事业管理专业硕士研究生(齐韶涵),全科医学与继续教育学院2015级全科医学专业硕士研究生(贾东梅)

收稿日期:2017-08-09 发布日期:2020-12-08
通讯作者: 王晨,Email：wangchen-tr2002@163.com
基金资助:
首都卫生管理与政策研究基地重大项目(2016JD01); 首都卫生管理与政策研究基地重点项目(2016JD02)

Study on impact of policy instruments on continuing education in H county of Beijing rural area

Dong Yi, Wang Chen, Li Na, Jiang Yue, Ma Li, Liu Lanqiu, Peng Yingchun, Jia Dongmei, Qi Shaohan

Hospital Office, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (Dong Y, Li N); General Practice Department, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (Wang C, Ma L); Medical Department, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (Jiang Y); Health Law Department of School of Health Administration and Education, Capital Medical University, Beijing 100069, China (Liu LQ); Medical Humanities Department of School of Health Administration and Education, Capital Medical University, Beijing 100069, China (Peng YC); Master?s Graduate Student in 2015, Social Medicine and Health Administration Major, School of Health Administration and Education, Capital Medical University, Beijing 100069, China (Qi SH); Master?s Graduate Student in 2015, General Practice Major, School of General Practice and Continuing Education, Capital Medical University, Beijing 100050, China (Jia DM)

Received:2017-08-09 Published:2020-12-08
Contact: Wang Chen, Email: wangchen-tr2002@163.com
Supported by:
The Significant Project of Research Center for Capital Health Management and Policy (2016JD01); The Important Project of Research Center for Capital Health Management and Policy (2016JD02)

摘要/Abstract

摘要： 目的了解北京市乡村两级即乡镇卫生院医务人员和乡村医生继续医学教育现状和政策工具对其具体影响。方法 2016年7月至8月,课题组根据地理位置、经济水平、历史文化等因素选取北京市H区C乡、J镇和B镇所辖乡镇卫生院及下辖21个行政村作为调查现场进行实地观察和个人深入访谈,采取质性研究中的目的性抽样方法,抽取21名乡镇卫生院医务人员、21名乡村医生、42名村民共计84人进行深入访谈。访谈内容包括个人基本信息,基本医疗服务提供,继续医学教育方式、学时、内容和效果等。结果 H区乡镇医务人员接受继续医学教育动力较足,“多形式、多渠道”培训形式得到医务人员基本肯定,培训内容得到认同,培训效果较好。在村一级,乡村医生接受继续医学教育动力较弱,“以会代训”和“网络化教学”的并轨使继续教育不同程度“走过场”,培训内容与实际需求存在差距,培训效果一般。结论直接性政策工具的规制方式和直接提供方式因为缺乏灵活性和竞争机制使乡村两级继续医学教育的作用不能充分发挥,需要以疾病谱变化为依据,增加“因地制宜、有的放矢”的培训内容,在强化考核的同时改进激励机制,调动医务人员的学习自主性与积极性。

关键词: 政策工具, 继续医学教育, 乡村两级, 影响因素

Abstract: Objective It is important to understand the status quo of continuing medical education in Beijing rural area and specific influences of policy instruments on it. Methods According to the geographical position,economic level,historical and cultural factors,from July to August,2016,the investigation group selected the J,C and B township of H county in Beijing as well as its 21 administrative villages as research field to conduct field observation and individual in-depth interviews. The sample included 21 township hospital doctors,21 village doctors,42 villagers as total of 84 people. Interview questions include: personal basic information,basic medical and public services,continuing medical education method,class hours,content,and effect. Results The status quo of continuing medical education in H County presented the following condition: township medical staffs were willing to accept continuing medical education,diverse forms and lessons’ contents were affirmed,the effect was overall better. At village level,village doctors accepting continuing medical education power was weak,education form combined with network teaching system conducted ineffectively,there was a gap between training content and actual demand,the effect was overall general. Conclusions Regulation and directly provision of direct policy tools had some drawbacks in terms of lack of flexibility and competition mechanism gave rise to negative action of continuing medical education. It was necessary to adjust contents and improve incentive mechanism for enhancing learning autonomy of township doctors.

Key words: Policy instruments, Continuing education, Township and village, Influencing factor

董屹, 王晨, 李娜, 姜悦, 马力, 刘兰秋, 彭迎春, 贾东梅, 齐韶涵. 政策工具对北京市乡村两级继续医学教育的影响分析[J]. 中华医学教育杂志, 2018, 38(1): 113-118.

Dong Yi, Wang Chen, Li Na, Jiang Yue, Ma Li, Liu Lanqiu, Peng Yingchun, Jia Dongmei, Qi Shaohan. Study on impact of policy instruments on continuing education in H county of Beijing rural area[J]. Chinese Journal of Medical Education, 2018, 38(1): 113-118.

参考文献

[1] B·盖伊·彼得斯,弗兰斯·K·M·冯尼斯潘.公共政策工具 [M].顾建光,译.北京: 中国人民大学出版社,2006: 13.
[2] 李侠,熊玉婷.政策工具的选择、收益与群体行为[J].科学与管理,2013 (3): 23-28,35. DOI: 10.3969/j.issn.1003-8256.2013.03.004.
Li X,Xiong YT.Study on selection,profit of policy instrument and group behavior[J].Science and Management,2013 (3): 23-28,35. DOI: 10.3969/j.issn.1003-8256.2013.03.004.
[3] 严强.公共政策学 [M].北京: 社会科学文献出版社,2008: 99-101,108.
[4] 蒋祎,汪洋,曾缓.新医改背景下我国农村医学教育的改革[J].复旦教育论坛,2012,10(1): 93-96.
Jiang Y,Wang Y,Zeng H.On the rural medical education reform under the background of new medical system reform in China[J].Fudan Education Forum,2012,10(1): 93-96.
[5] 卫生部.继续医学教育规定(试行)(卫科教发 [2000] 477号) [EB/OL].[2017-06-20].http://wenku.baidu.com/link?url=E4axfClc0BljnBiqnF2dMZ0TkaYD26sFUYxYfjc-DNhMKbBTWgdVbs1t3XzqgqrvlFXJ4xFDiC299P11DLdyZTOlLlumPxVgQEa_BMzlsoi.
[6] 卫生部,国家发展与改革委员会,财政部,等.乡镇卫生院管理办法(试行)(卫农卫发 [2011] 61号) [EB/OL].[2016-07-26].http://www.nhfpc.gov.cn/zwgk/wtwj/201304/aee238407a984102ad51619065210902.shtml.
[7] 国家卫生和计划生育委员会,国家发展与改革委员会,教育部,等.村卫生室管理办法(试行)(国卫基层发 [2014] 33号 [EB/OL].[2016-07-26].http://www.nhfpc.gov.cn/jws/s3581/201406/55de 13fd597a4918bfc42e3a5b7ff2b8.shtml.
[8] 北京市人事局,北京市卫生局,北京市教育委员会,等.关于加强北京市社区卫生人才队伍建设的实施意见(京人发 [2006] 74号) [EB/OL].[2017-07-17].https://www.lawxp.com/statute/s77133 2.html.
[9] 中共北京市委组织部,中共北京市卫生局党组.关于印发《关于加强卫生人才队伍建设的意见》的通知(京卫发 [2010] 20号) [EB/OL].[2017-07-24].http://www.51wf.com/print-law?id=2109020.
[10] 国家卫生和计划生育委员会,国家发展与改革委员会,教育部,等.全国乡村医生教育规划(2011-2020年)(国卫科教发 [2013] 26号) [EB/OL].[2017-06-30].http://www.nhfpc.gov.cn/qjjys/s 3593/201310/a01af8848c7f4ae081985ff4744461ee.shtml.
[11] 熊烨.政策工具视角下的医疗卫生体制改革: 回顾与前瞻——基于1978-2015年医疗卫生政策的文本分析[J].社会保障研究,2016 (3): 51-60.
Xiong Y.Medical and health system reform from the perspective of policy tools: Retrospect and prospect——based on the text analysis of the 1978-2015 health policies[J].Social Security Studies,2016 (3): 51-60.
[12] 姚力.“把医疗卫生工作的重点放到农村去”——毛泽东“六·二六”指示的历史考察[J].当代中国史研究,2007,14(3): 99-104,128.
Yao L.“Shift the priority of medical and health work to the rural areas”: A historical investigation of Mao Zedong’s instruction on 26 June 1965[J].Contemporary China History Studies,2007,14(3): 99-104,128.
[13] 北京市卫生局,北京市发展与改革委员会.关于落实1486个村卫生机构标准化建设计划的实施方案(京卫基层字 [2005] 8号) [EB/OL].[2017-07-15].http://www.bjchfp.gov.cn/zwgk/ghjh1/20 1612/t20161221_205499.htm.
[14] 林光汶,郭岩,Legge,D.等.中国卫生政策 [M].北京:北京大学医学出版社,2009: 134.
[15] 刘圣中.现代科层制: 中国语境下的理论与实践研究 [M].上海: 上海人民出版社,2012: 50,98.

政策工具对北京市乡村两级继续医学教育的影响分析

Study on impact of policy instruments on continuing education in H county of Beijing rural area

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价

[1]	葛文嘉, 魏静, 徐婉斐, 任瑞民. 某高校医学硕士研究生的心理健康相关因素调查分析[J]. 中华医学教育杂志, 2020, 40(8): 582-585.
[2]	董亚莉, 赵婷, 顾晓芬. 焦虑和抑郁水平现况及影响因素研究[J]. 中华医学教育杂志, 2020, 40(8): 586-589.
[3]	吴雪霁, 汪慧, 张玉华, 毛及, 刘玉清, 景钦隆, 罗雷, 张周斌. 基于微信的新型冠状病毒肺炎疫情基层防控继续教育平台的应用[J]. 中华医学教育杂志, 2020, 40(8): 610-614.
[4]	赵勋, 何启瑜, 覃子健, 徐思梦, 周丹丹, 梁朝朝, 冯文. 高校学生对医患关系及其影响因素认知的调查[J]. 中华医学教育杂志, 2018, 38(4): 519-522.
[5]	高琼, 姜玉新, 李建初, 席雪华, 刘如玉, 高璐滢, 王莹, 张波. 基于甲状腺超声学习班问卷调查结果的继续医学教育研究[J]. 中华医学教育杂志, 2018, 38(4): 604-607.
[6]	许军军, 冯艺. 自媒体助力医学专业人员的继续医学教育探析[J]. 中华医学教育杂志, 2018, 38(3): 460-463.
[7]	王秋梅, 朱鸣雷, 康琳, 陈紫薇, 邢珊珊, 刘晓红. 老年长期照护服务机构专业人员的老年医学继续教育现状和需求调查[J]. 中华医学教育杂志, 2018, 38(3): 464-467.
[8]	王冬阳, 朱滨海, 戴小婷, 马真. 巴西继续医学教育制度评析[J]. 中华医学教育杂志, 2018, 38(3): 474-479.
[9]	李艳君, 郭启勇, 杨清, 于宏, 陈琦. 中国医科大学部分专业课堂教学质量影响因素的分析[J]. 中华医学教育杂志, 2018, 38(1): 1-6.
[10]	韩春蕾, 崔倩倩, 何然, 杨佳, 王颖, 孙红卫, 王玖. 医学生儿科就业意愿的影响因素分析[J]. 中华医学教育杂志, 2018, 38(1): 28-31.