As the most basic unit of infectious disease prevention and control, community health service institutions are the frontline and important gateway for the prevention and control of infectious disease. Primary care physicians are responsible for epidemic surveillance, vaccination, health promotion and assistance to centers for disease control in investigating and disposing outbreaks and public health emergencies in their districts, and play an active role in disease prevention and control by groups, susceptible population protection, infectious source control and health education, as well as the effective prevention and control of infectious diseases.

To understand the ability of primary care physicians to diagnose and treat infectious diseases in the community, analyse their existing problems and shortcomings, design and conduct a series of intensive training related to infectious diseases for improving the capacity of infectious disease prevention and control at the primary level; To evaluate the effectiveness of online continuing medical education, so as to provide a reference for better continuing medical education on infectious diseases in the community.

All participants of the National Community Infectious Diseases Continuing Education Conference held by the Department of Family Medicine of the University of Hong Kong-Shenzhen Hospital in November 2021 were selected as research subjects from November 2021 to March 2022. The questionnaires were distributed to all registered attendees before and after the conference through the QR code of the questionnaire star, and the content of pre-conference questionnaire included demographic characteristics of the participants, participation in infectious disease training in the community since started working, diagnosis and treatment of infectious diseases in the community, subjective attitudes towards the prevention and control of infectious diseases in the community (willingness to manage infectious diseases in the community, satisfaction with their own infectious disease management skills), expertise in infectious disease prevention and control and knowledge related to conference content, attitude towards hepatitis B. The content of the post-conference questionnaire mainly included knowledge about the content of conference, attitude towards hepatitis B and satisfaction survey of this online conference. A total of 301 primary care physicians completed the questionnaire before and after the conference, and a total of 194 completed the questionnaire before and after the conference.

Among all participants, 166 (55.1%) had attended infectious disease training in the community, of whom 49 (29.5%) were satisfied with their infectious disease diagnosis and treatment ability; 135 (44.8%) had not attended the training, of whom 22 (16.3%) were satisfied with their infectious disease diagnosis and treatment ability. 143 (86.1 %) of 166 participants who had attended infectious disease training in the community indicated their willingness to manage community infectious diseases, 99 (73.3%) of 135 participants who had not attended infectious disease training in the community indicated their willingness to manage community infectious diseases. 66 (27.3%) of participants who were satisfied with their infectious disease diagnosis and treatment ability indicated their willingness to manage community infectious diseases. The top three infectious disease tests conducted by the institutions were hepatitis B, AIDS, and hepatitis C; the top three infectious diseases treated in the past six months were hepatitis B, influenza, hand, foot and mouth disease. Different self-evaluation and willingness to train may affect the willingness to manage community infectious diseases (P<0.05). Among the participants who completed the questionnaire both before and after the conference, the highest correct answer rate for compulsory management of statutory infectious diseases before the conference was 89.7%, the lowest accuracy rate for the type of disinfection of the COVID-19 infection was only 17.0%, the correct rates of other questions ranged from 34.0% to 40.7%. The correct rates of the questions after the conference were higher than those before the conference, and the correct rates ranged from 48.9% to 52.6%. The score of attitude towards hepatitis B after the conference was higher than that before the conference (P<0.05). In terms of feedback after conference, 254 (98.1%) expressed satisfaction in the total of 259 questionnaires. In terms of suggestions for online conference, 179 (69.1%) and 174 (67.2%) participants believed that online fluency and online interaction need to be improved.

The primary care physicians receive relatively less infectious diseases training in the community, inadequate infectious diseases training in the community can improve the confidence of self-competence, attitude of active management of infectious diseases and diagnosis and treatment ability in the primary care physicians. The future direction of continuing medical education should focus on the training of emerging infectious diseases and novel medical concepts, relevant experts should be invited to comment on the necessity and effectiveness of training in the community.

社区卫生服务机构作为传染病防控工作的最基层单位，是传染病防治的前沿阵地和重要关口，基层医务工作者承担着辖区内疫情监测、预防接种、健康宣传及协助疾控部门调查处置暴发疫情和突发公共卫生事件等职责，在疾病群防群控、易感人群保护、传染源控制及健康宣教等方面发挥着积极作用，同时对有效防控传染病发挥关键作用。

了解基层医务工作者社区传染病的诊治能力，分析存在的问题和薄弱方面，有针对性地设计及开展传染病相关系列培训，提高基层传染病防控能力。

2021年11月—2022年3月以香港大学深圳医院全科医学科在2021年11月举办的国家级社区传染性疾病继续教育会议的所有参会者为研究对象。会前、会后通过问卷星二维码向参会者发放调查问卷，会前问卷内容包括参会者人口学特征，工作后是否参加过社区传染病培训，社区传染病诊治开展情况，社区传染病防治的主观态度（是否愿意管理社区传染病、对自己传染病诊治能力满意度），传染病防治专业知识及会议内容相关知识，对慢性乙型肝炎的态度。会后问卷内容主要为会议内容相关知识、对慢性乙型肝炎的态度以及对本次线上会议满意度调查。会前共有301名基层医务工作者完成调查问卷，会前及会后均完成调查问卷共有194名。

工作后参加过社区传染病培训的有166名（55.1%），其中评价对自己传染病诊治能力表示满意的有49名（29.5%）；未参加过的有135名（44.8%），评价自己传染病诊治能力表示满意的有22名（16.3%）。是否愿意管理社区传染病：参加过社区传染病培训的166名中有143名（86.1%）表示愿意；未参加过培训的135名中表示愿意的有99名（73.3%）。而对自己传染病诊治能力满意的人中66名（27.3%）表示愿意管理社区传染病。所在单位开展的传染病检测中，前三位分别是慢性乙型肝炎、艾滋病和慢性丙型肝炎；过去半年内接诊过的传染病排名前三位分别是慢性乙型肝炎、流感和手足口病。不同自我评价、培训意愿可能影响管理社区传染病意愿（P<0.05）。会前及会后均完成问卷的参会者中，会前对于强制管理的法定传染病回答正确率较高为89.7%，而对新型冠状病毒感染消毒类型的正确率仅有17.0%，其他题目的正确率为34.0%~40.7%；其他题目会后正确率均高于会前，正确率为48.9%~52.6%。对慢性乙型肝炎的态度方面，会后得分高于会前（P<0.05）。会后反馈方面，共259份问卷其中表示满意的有254名（98.1%）。其中对线上会议的建议方面，179名（69.1%）和174名（67.2%）认为网络流畅度和线上互动程度需要提高。

基层医务工作者接受的社区传染病培训较少，通过传染病培训能提高基层医务工作者对自我能力的肯定及积极管理社区传染病的态度，同时也能提高其诊治能力。今后医学继续教育的方向应着重对新发传染病、新医学概念的培训，就社区培训的必要性及培训效果问题邀请相关专家进行了点评。