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首页> 外文期刊>BMC Medical Education >Medical education reform in Tajikistan: comparison of the conventional one-year family medicine residency program and the new two-year residency program for postgraduate medical education
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Medical education reform in Tajikistan: comparison of the conventional one-year family medicine residency program and the new two-year residency program for postgraduate medical education

机译：塔吉克斯坦的医学教育改革：传统的一年家庭医学居住计划与新一年后医学教育的两年居留计划的比较

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The last two decades have seen a shift in former Soviet countries from highly specialized to more family medicine-focused systems. Medical education has slowly adjusted to these reforms, although the region is still at risk to have a chronic shortage of family doctors. This paper presents the evaluation of a new post-graduate family medicine program in Tajikistan, focused on competency-based training. The findings are relevant for policy makers, international organizations and practitioners participating in similar medical education reform programs. We employed a quasi-experimental control group design and compared intervention residents, control group residents with traditional training, and 1st year residents with no training in two outcomes, clinical knowledge and competencies. We employed two objective measures, a written multiple-choice question test (MCQT) and an Objective Structured Clinical Examination (OSCE), respectively. We report reliability and validity of the measures along with ANOVA, planned contrasts and effect size estimates to examine differences across groups. We found statistically significant differences in both clinical knowledge and competencies between intervention and control groups. We also detected a large intervention effect size. Participants in the intervention outperformed control group participants in the two measures. Our analysis suggests that intervention and control group participants are comparable in terms of initial knowledge and competencies, strengthening the argument that the intervention caused the improvement in the program outcomes. Receiving tailored training and structured opportunities to practice knowledge and competencies in clinical settings have a positive effect on the education of family medicine doctors in Tajikistan. Our results support curriculum reform and investment in medical education in the form of longer and supervised on-the-job preparation designed to be more in line with international standards. We discuss suggestions for future studies and potential requirements to inform replicability in other countries. Family medicine is well recognized as central to health systems throughout the world, but high quality residency training lags behind in some countries. Our study showed that investing in family medicine residency programs and structured training is effective in increasing critical clinical competencies. We encourage promoting comprehensive post graduate family medicine doctor training so that the goals of a family medicine centered health system are attainable.
机译：过去二十年来看，前苏联国家的转变从高度专业为更多的家庭医学的系统。医学教育慢慢调整了这些改革，尽管该地区仍然有风险，以患有慢性缺乏家庭医生。本文介绍了塔吉克斯坦新毕业生家庭医学计划的评估，重点是基于能力的培训。这些调查结果与参与类似医学教育改革方案的政策制定者，国际组织和从业者有关。我们雇用了一种准实验控制组设计和比较的介入居民，控制群体居民，传统培训，1年居民，没有两种结果，临床知识和能力。我们雇用了两项客观措施，是一项书面的多项选择问题测试（MCQT）和客观结构化临床检查（欧安组织）。我们报告措施的可靠性和有效性以及ANOVA，计划对比和效果规模估计，以检查跨组的差异。我们发现干预和对照组之间的临床知识和能力的统计学意义差异。我们还检测到大小的干预效果大小。参与者在干预方面表现出对照组参与者的两项措施。我们的分析表明，干预和对照组参与者在初始知识和能力方面是可比的，加强干预导致计划成果的改善的论点。在临床环境中练习知识和能力的定制培训和结构化机会对塔吉克斯坦的家庭医学医生进行了积极影响。我们的成绩支持课程改革和课程改革和医学教育的投资，以更长和监督的工作准备，旨在更加符合国际标准。我们讨论未来的研究和潜在要求的建议，以便在其他国家/地区提供可重复的可复制性。家庭医学很好地被认可为全球卫生系统的核心系统，但高质量的居住培训在一些国家落后。我们的研究表明，投资家庭医学居住计划和结构化培训在增加关键临床能力方面是有效的。我们鼓励促进全面的毕业生家庭医学卫生培训，以便达到家庭医学中心卫生系统的目标。

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