Research on continuing education for general practitioners in China over the past decade: a systematic review
Shuyu Hou, Xin Zeng, Wang Ting-ting, MOU Biao, Lei Yu, WU Fuju, Luo Xiao-hong, ZOU Chuan
Abstract
With shifts in disease patterns and the implementation of tiered healthcare, general practitioners (GPs) play a vital role in disease diagnosis and management. The rapid advancement of medical knowledge and evolving health service demands necessitate continuing education for GPs to provide optimal clinical decision-making and disease management. This study analyzes the development trends, training quality, and research quality of continuing medical education (CME) for GPs in China over the past decade (2013–2022). In January 2023, eight databases (PubMed, Cochrane Library, Embase, CINAHL, ERIC, CNKI, Wanfang Data, and CBM) were searched for studies on CME for Chinese GPs, covering publications from January 2013 to December 2022. The Medical Education Research Study Quality Instrument (MERSQI) was used to systematically evaluate study quality. A total of 49 studies were analyzed, including 11 in English and 38 in Chinese. Training themes focused primarily on cardiovascular diseases (22.4 %), emergency care (6.1 %), and mental health (6.1 %). Most training was lecture-based (69.3 %), with only 6.1 % using skill-based formats and 4.0 % employing problem-based (PBL) or team-based (TBL) learning. Rigorous evaluation was lacking in most studies: 63.2 % ( n = 31) used surveys to assess outcomes, with 19 lacking reliability and validity considerations. Study designs were predominantly single-group pre- and post-tests (53.1 %), with 26.5 % using randomized controls and only 4.1 % incorporating controlled pre- and post-test designs. Only 18.3 % ( n = 9) reported ethical considerations; most studies (81.7 %) did not mention it. Assessment largely focused on knowledge and skill gains (85.7 %) with limited evaluation of behavioral changes (14.2 %) or benefits to patients and healthcare institutions (22.4 %). Research on general practice CME in China over the past decade has been limited in scope but shows significant growth potential. Future CME efforts should broaden topic coverage, diversify instructional methods, use validated assessment tools, and prioritize training-induced behavioral changes and patient outcomes to improve the multidimensional quality of general practice education programs.