Abstract: Background　Continuing medical education is a significant way for general practitioners（GPs） to improve the skills of diagnosis and treatment，however，the design of the education programs should satisfy the needs of GPs and should be suitable for GPs with different professional skills. Objective　To investigate the factors associated with results of a training as a continuing medical education program in GPs and their training needs based on a survey，providing a reference for developing appropriate continuing education programs for GPs. Methods　Data of GPs who participated in an online continuing education program of diagnosis and treatment of common diseases in primary care conducted in Shanghai from October to December 2019 were collected，including demographics，score of test of the training contents，needs of contents and forms of training，and satisfaction with training. The associations of training test score with years of attending consecutive trainings，geographical location of the working area，and professional title were analyzed. The associations of needs of training contents with geographical location of the working area，and professional title were analyzed. Spearman's correlation was used to analyze the correlation between satisfaction with training contents and training test score. Results　A total of 3 344 GPs completed this training，whose average test score was（4.80±2.67）. GPs with two consecutive years（2018 and 2019） of trainings had much higher test score than those with one-year training（2019）〔（5.09±2.60）vs（4.15±2.71），P<0.05〕. Suburban GPs had much higher test score than urban GPs〔（4.97±2.68）vs（4.30±2.58），P<0.05〕．The test score〔（3.77±2.73）〕 of GPs with no professional title was much lower than that〔（4.82±2.65）〕 of those with a junior professional title or intermediate title 〔（4.85±2.65）〕（P<0.05）. Suburban GPs were in more need of trainings regarding guidance on residents' self-management of hypertension and diabetes，home-based stroke rehabilitation，emergency knowledge and skills，gynecology and obstetrics and pediatrics treatment，and coronary heart disease prevention and treatment，while urban GPs were in more need of trainings regarding the skills of imaging and electrocardiogram diagnosis（P<0.05）. GPs with no professional title had greater needs for trainings regarding nutrition knowledge，psychological knowledge and doctor-patient communication skills（P<0.008），while those with junior professional title had greater needs for trainings regarding the skills of imaging and electrocardiogram diagnosis（P<0.008），and those with an intermediate professional title had greater needs for trainings regarding emergency knowledge and skills（P<0.008）. GPs were highly satisfied with the training content（92.54%，844/912）. The test scores was positively correlated with the satisfaction evaluations of the training content （r=0.098，P<0.05）. Mobile phone-based training was the most popular form of training（92.16%，762/1 198）. Conclusion　In comparison，the effect of regular trainings of general practitioners continuously is better, and there are differences in the training content needs of general practitioners in suburban areas and different titles. We put forward the following suggestions in accordance with the survey: carrying out regular trainings continuously as continuing medical education for GPs；modifying the difficulty degree of trainings and compiling training contents according to geographical location of the working area and professional title；recruiting professionals who are familiar with primary care as the teachers for trainings，and compiling training contents according to the needs of primary care workers；promoting the application of the form of mobile phone-based training.

Key words: General practitioners, Continuing medical education, Diagnosis and treatment knowledge

摘要： 背景　继续医学教育作为提升全科医生诊疗能力的重要途径，其设计必须满足全科医生诊疗需求及适应不同全科医生技能水平。目的　通过分析影响全科医生继续教育培训成绩与培训需求的因素，为组织适合全科医生的继续教育培训提供参考和依据。方法　收集2019年10—12月参加上海市全科医生基层常见病诊疗知识在线继续教育培训的全科医生基本情况、培训成绩、培训内容需求评价、培训内容满意度与培训形式需求评价数据。分析全科医生培训成绩在连续培训时间、城郊区、不同职称之间的差异；分析不同培训内容需求在城郊区、职称之间的差异；采用Spearman秩相关分析培训内容满意度与考试成绩的相关性。结果　完成培训的全科医生3 344例，培训平均成绩为（4.80±2.67）分。连续参加2018、2019年两年培训的全科医生在2019年的成绩〔（5.09±2.60）分〕高于只参加2019年培训的全科医生〔（4.15±2.71）分〕，差异有统计学意义（P<0.05）；郊区全科医生成绩〔（4.97±2.68）分〕高于城区全科医生〔（4.30±2.58）分〕，差异有统计学意义（P<0.05）；无职称全科医生成绩〔（3.77±2.73）分〕低于初级职称〔（4.82±2.65）分〕、中级职称〔（4.85±2.65）分〕，差异有统计学意义（P<0.05）。郊区全科医生对指导居民高血压、糖尿病的自我健康管理技能与脑卒中家庭康复的技能方面的培训以及“急诊急救”“妇产科儿科”及“冠心病防治”方面的培训需求更高，而城区全科医生对“影像学与心电图”培训需求更高（P<0.05）。与无职称全科医生相比，初级职称全科医生对“影像学与心电图”方面的培训需求更高（P<0.008），中级职称全科医生对“急诊急救”培训需求更高（P<0.008）；无职称全科医生对“营养学”“心理学与医患沟通”培训需求高于初、中、高级职称全科医生（P<0.008）。全科医生对本次培训内容满意度为92.54%（844/912），培训内容满意度与培训成绩呈正相关（r=0.098，P<0.05），92.16%（762/1 198）希望接受“手机客户端线上培训。结论　比较而言，连续性定期性的全科医生继续教育培训效果更佳，城郊区、不同职称全科医生培训内容需求存在差异。建议组织具有连续性、定期性计划的全科医生继续教育培训；调整培训难度、培训内容，满足不同地区、职称全科医生的需求；选择熟悉基层卫生工作的师资科学制定适合基层工作需求的培训内容；创新培训形式，加强手机客户端这一便捷培训形式的推广应用。

关键词: 全科医生, 继续教育, 诊疗知识