Page 14 - 2022-22-中国全科医学

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implementation effect of the free training policy，as well as the long-term development of the primary care health talent team.
Objective To review the research progress of related studies on rural service orientation project in China and similar projects
abroad，summarize the execution process and execution results of the projects inductively，and compare the similarities and
differences between domestic and foreign studies. Methods The study was conducted from July to September 2021. A literature
search for Chinese language was conducted in CNKI，Wanfang Data Knowledge Service Platform and VIP，and the search time
was set from 2010-07-01 to 2021-07-01. A literature search in English was conducted in PubMed，web of science，Scopus，
and the search time was set from 2000-01-01 to 2021-07-01. Literature screening was performed according to the inclusion and
exclusion criteria，relevant information was extracted，and the literature was classified and analyzed according to the subjects and
contents of the studies. Results A total of 443 articles were finally included，with 427 of them on our rural service orientation
project in China and the rest 16 on similar projects abroad. The research topics that were studied in the literature included four
broad categories：cultivation mode，enrollment，training process，and employment development. In 427 related literatures of
China's rural service orientation project：102（23.9%） discussed the training mode of rural service oriented project. Ten（2.3%）
analyzed the admission status of rural service directed medical students and found that rural service directed medical students
had higher awareness rate of the related policies（>75.0%-90.9%） and the proportion of rural students sources was higher
（57.6%-84.2%）. 270（63.2%） literatures used the cultivation process of rural service directed medical students as a starting
point and focused on their learning situation，professional identification and performance willingness，and found that rural service
directed medical students had lower academic performance and professional recognition than general clinical medical students.
The results of studies on the performance willingness of rural service directed medical students varied greatly（42.4%-98.4%），
and the average performance willingness was 66.2% when weighted by sample size. Only 25（5.9%） studied employment
development in rural service orientated graduates and found an average performance rate of 93.6%. Rural service directed medical
students had a faster rate of completing standardized residency training and passing practitioner examination than other five-year
clinical graduates. Of the 16 foreign related literatures included，11（68.8%） examined the employment development of rural
service directed medical graduates and obtained results similar to those of domestic studies. Conclusion A larger number of
current studies focused on rural service oriented project and had rich topics. It was found that the rural service directed free medical
student training policy was better implemented，leading to a large number of excellent primary health talents in the Midwest.
However，most of the current research focuses on the cultivation stage of rural service oriented medical students，and there is
insufficient understanding of medical students who have joined the primary care team at elementary level. Future research should
focus on three aspects：performance status after rural service directed medical students having completed the contract period，
career development process after employment and the actual role they play in primary health care institutions.
【Key words】 General practitioners；Target admissionmedical graduates；Education，medical；Health policy；
Primary health care；Review

自 2010 年国家发展改革委等 5 部门印发《关于 机构服务一定期限的培养项目，为统一名称，以下
开展农村订单定向医学生免费培养工作的实施意见》 拟称作国外订单定向项目）研究进行综述分析，归
（发改社会〔2010〕1198 号）以来，订单定向医学 纳已发表研究的主题和结果，并比较国内外研究的
生免费培养项目（简称订单定向项目）每年为我国 异同之处，以期对订单定向项目研究现状进行总结，
中西部基层医疗卫生机构培养超过 5 000 名全科卫生 并提出对未来的研究展望。
人才 ［1-2］ ，为提高我国农村地区的医疗服务可及性 1 资料与方法
和医疗服务质量等做出了卓越贡献。10 余年间，我 1.1 文献检索策略 于 2021 年 7—9 月，在中国知
国学者针对订单定向项目开展了一系列研究，得到 网、万方数据知识服务平台、维普网进行中文文献
了大量线索与证据，但目前针对订单定向项目文献 检索，在 PubMed、Web of Science、Scopus 进行英文
的综述分析相对较少。魏艳君等 ［3］ 采用 CiteSpace 工 文献检索，并对获得文献的参考文献进行补充检索。
具对我国订单定向项目研究现状进行文献计量学分 提取研究的关键词，对文献的标题、摘要和关键词
析，主要探讨了研究热点和研究趋势，针对研究结 进行高级检索。中文关键词包括：“订单定向”或
果的分析欠深入。本研究旨在对目前已开展的订单 “订单式”或“免费”或“定向培养”，“医学生”
定向项目研究及国外相似项目（指大学期间给予医 或“医学毕业生”或“全科医生”或“临床医生”。
学生一定激励，但要求毕业后义务到基层医疗卫生 英文关键词包括：“oriented” 或“compulsory”，