乡镇卫生院卫生技术人员在职培训管理存在的主要问题及其原因

来自各利益相关者的调查表明，乡镇卫生院卫生技术人员在职培训存在的主要问题依次为：乡镇卫生院发展方向不明影响卫生技术队伍建设，技术岗位入口管理不严及卫技人员界定不清影响卫生技术队伍质量，缺乏明确的政策规定影响卫技人员在职培训制度的建立，缺乏规范的管理制度影响卫技人员在职培训机制的形成，在职培训没有与管理者业绩和卫技人员表现挂勾，影响组织和参加培训的积极性。针对问题，提出了相应的政策建议。     

卫生部《乡镇卫生院卫生技术人员培训暂行规定》

第一章　总则第一条　为贯彻落实《中共中央、国务院关于进一步加强农村卫生工作的决定》和卫生部等五部委《关于加强农村卫生人才培养和队伍建设的意见》 ,建立健全农村卫生技术人员在职培训制度 ,不断提高乡镇卫生院卫生专业技术人员 (以下简称卫技人员 )的服务水平 ,以适应农村卫生改革与发展的需要 ,特制定本规定。第二条　本规定适用于全国乡镇卫生院在职卫技人员。第三条　本规定所指卫技人员是指在乡镇卫生院从事医疗、护理、药剂、预防保健及其他相关卫生专业技术工作的人员。第四条　本规定中的培训是指对乡镇卫生院卫技人员进行以…     

建立乡镇卫生院卫生技术人员在职培训制度的思考

提出了建立健全乡镇卫生院卫生技术人员在职培训制度的基本框架，构建了贯彻执行在职培训制度的基本机制。对乡镇卫生技术人员在职培训制度的建立对乡镇卫生院工作可能产生的潜在作用和深层次影响进行了讨论。     

189所乡镇卫生院卫生技术人员结构及在职培训现状的调查

乡镇卫生院有12．75％的上岗者未经医学院校培训(20世纪90年代以来)。现有乡镇卫技人员中，无正规专业学历者占21．79％，未获得中级及以上专业技术职称者占86．21％。绝大多数卫生院未建立在职培训制度，卫技人员一周以上培训率为73．86％，人均年培训0．2次。中部、西部、东部地区之间卫技人员受教育层次比率、培训次数有所不同。不同省份之间乡镇卫技人员与农村其它卫技人员比例也有差异。     

乡镇卫生院卫生技术人员培训暂行规定

为贯彻落实《中共中央、国务院关于进一步加强农村卫生工作的决定》和卫生部等五部委《关于加强农村卫生人才培养和队伍建设的意见》，建立健全农村卫生技术人员在职培训制度，不断提高乡镇卫生院卫生专业技术人员(以下简称卫技人员)的服务水平，以适应农村卫生改革与发展的需要，特制定本规定。     

西北某市乡镇卫生院卫生人力资源现况调查及配置公平性评价

目的了解西北某市乡镇卫生院卫生人力资源现状,评价配置公平性,为政府制定政策提供依据。方法运用描述性统计方法分析乡镇卫生院卫生人力的数量、质量、结构和分布等情况。综合运用基尼系数和泰尔指数评价各区、县各类卫技人员人口分布公平性。结果全市卫生院千人口卫技人员数为0.90人。在各类卫技人员中,预防保健人员和护理人员数量相对不足。卫技人员学历和职称结构均较低。山区卫生院卫技人员数量和素质均较低。临床人员、医技人员、护理人员和预防保健人员人口分布基尼系数依次为0.38、0.45、0.45和0.46。结论该市乡镇卫生院卫技人员数量相对不足,卫技人员素质不高,专业结构不合理。不同地形卫生院卫技人员的数量和质量分布不均衡。在各类卫技人员中,临床人员人口分布公平性最好,而预防保健人员最差。     

江苏省乡镇卫生院卫生人力资源现况调查与分析

目的 了解江苏省乡镇卫生院卫生人力资源现状,发现存在的问题并提出对策建议.方法 采用普查法搜集江苏乡镇卫生院卫生人力资源的相关信息,对性别、年龄、学历、职称以及各类卫技人员的配置情况进行描述性统计分析.结果 江苏乡镇卫生院卫生、卫技人员数量相对充足;卫技人员年龄机构比较合理,中青年居多,本科及以上学历占比较低,技术职称普遍不高,以中级以下职称为主;口腔类医师以及B超、心电图等类别医技人员的配备率相对较低.结论 主管部门应该科学合理地对卫生人力资源进行配置,重点应放到提高卫技人员的专业素质、优化职称结构和进一步完善各类卫技人员的配置结构上.     

权力下放对乡镇卫生院卫生人力资源管理的影响研究

该文旨在了解卫生管理权力下放对乡镇卫生院卫生人力资源管理的影响。采用定性与定量相结合的方法在福建省某地区的两个县开展研究。结果表明 :实施卫生管理权力下放后 ,乡镇卫生院在人员录用、解聘及调动等方面拥有了更大的自主权 ;卫技人员参加在职培训的机会增多 ,但对预防保健人员的培训有所忽略 ;另外 ,新的薪酬制度虽然提高了卫生人员的积极性和收入 ,但在医疗费用和服务质量等方面出现了一些负面效应     

临床评价指导对乡镇卫生院卫技人员服务行为影响的研究

依据乡镇卫生院工作描述和任务分析制订“乡镇卫生院临床评价标准”。通过自评和组评方式发现和解决卫技人员在临床技能和服务态度方面存在的问题和不足，从而确定培养需求，设计卫技人员在岗培训计划。试点研究发现。临床评价指导对促进乡镇卫技人员服务工作的标准化和规范化具有显著作用。     

经济欠发达地区乡镇卫生院卫生人力现状分析

通过对江西省3县72所乡镇卫生院的调查，分析了乡镇卫生院卫生人力数量，卫技人员专业分布及不同卫生院卫生人力的差别，并与全国农村卫生人力资料进行了比较，就合理配置经济欠发达地区乡镇卫生院卫生人力提出了几点建议。     

加强全科医师队伍建设 推动社区卫生服务工作

丰台区卫生局为培养、建立并发展一支高素质的高科医学专业人才队伍进行了积极探索和尝试。制定全科医师队伍发展规划;培育全科医学教学、实习基地;组织高质量的师资力量;对全区医疗卫生机构的领导干部、业务骨干、基层医疗人员进行了全科医学在职学历教育、学科带头人教育和在职专业证书教育等多层次、多渠道培训,逐步建立起良好的全科医学培训机制,将全区的全科医疗培训工作纳入规范化管理轨道,有力推动了社区卫生服务工作的     

农村卫生技术人员素质现状与培训需求研究

目的：通过调查了解农村乡镇卫生院卫生技术人员的业务素质与接受专业培训现状，并调查了解他们对未来培训的需求。调查发现，3个样本县乡镇卫生院卫生技术人员有9．9％无专业，苏南、苏中、苏北差距不大。过去5年内有70％以上的人接受过培训。对未来3年的培训需求调查则发现，高职称人员对培训需求相对稍低，高学历人员的培训需求较高。建议采取有效措施，通过培训与分流相结合提高农村卫生技术人员专业索质，开展经常性的业务培训，跟上知识更新的步伐，并针对不同层次人员的需求，开展有目的、有计划的业务培训活动。     

Building health workforce capacity for planning and monitoring through the Strengthening Technical Assistance for routine immunization training (START) approach in Uganda

IntroductionThe Global Vaccine Action Plan identifies workforce capacity building as a key strategy to achieve strong immunization programs. The Strengthening Technical Assistance for Routine Immunization Training (START) approach aimed to utilize practical training methods to build capacity of district and health center staff to implement routine immunization (RI) planning and monitoring activities, as well as build supportive supervision skills of district staff.MethodsFirst implemented in Uganda, the START approach was executed by trained external consultants who used existing tools, resources, and experiences to mentor district-level counterparts and, with them, conducted on-the-job training and mentorship of health center staff over several site visits. Implementation was routinely monitored using daily activity reports, pre and post surveys of resources and systems at districts and health centers and interviews with START consultants.ResultsFrom July 2013 through December 2014 three START teams of four consultants per team, worked 6 months each across 50 districts in Uganda including the five divisions of Kampala district (45% of all districts). They conducted on-the-job training in 444 selected under-performing health centers, with a median of two visits to each (range 1–7, IQR: 1–3). More than half of these visits were conducted in collaboration with the district immunization officer, providing the opportunity for mentorship of district immunization officers. Changes in staff motivation and awareness of challenges; availability and completion of RI planning and monitoring tools and systems were observed. However, the START consultants felt that potential durability of these changes may be limited by contextual factors, including external accountability, availability of resources, and individual staff attitude.ConclusionsMentoring and on-the-job training offer promising alternatives to traditional classroom training and audit-focused supervision for building health workforce capacity. Further evidence regarding comparative effectiveness of these strategies and durability of observed positive change is needed.     

卫生管理队伍职业化探究

卫生管理干部职业化是《中共中央、国务院关于卫生改革与发展》中提出的具有重大战略意义和深远历史意义的指导方针。北京地区的卫生管理干部大多数是由卫校专业技术岗位转做卫生管理工作,没有或很少接受管理科学知识系统培训。在阐述卫生管理队伍职业化的概念后提出其涵盖的６个方面：工作专职化、职位序列化、知识“Ｔ”型化、能力专业化、意识现代化、配置方式多样化。从资源和生产力构成两个方面论述了卫生管理干部职业化的意义     

Towards development of professional management in Indian hospitals

Hospitals consume the largest share of government health resources, yet, until recently, they have not been a focus of health policy and research in developing countries, where the resources are in negative proportion to the demands placed on services of health care institutions, and where the possibility of resources being increased in the short run is very remote, the only hope for the increase in the effectiveness of the health care system being the effective management of hospitals. A professional administrator with multidisciplinary training would ensure the optimal use of resources. We live in the age of perfection at all levels. Hence, professional training is the basic requirement for the personnel to function effectively in a hospital. Professional training is required to be imparted by the institutions specialised in professional training. Professional management has an immense scope and a bright future market on account of the increasing demand for specialised and quality health care. Better management or lack of it will determine the future of health service. This paper focuses on development of management and the requirement for professional administrators in India.     

The ethical dimension of professional training in health: a case study in undergraduate dentistry courses

This case study sought to delineate an overview of ethics training on Brazilian undergraduate dentistry courses, in order to gather knowledge related to the changes required with regard to training ethically competent health professionals. Thus, the scope of this study ethics training of students was defined by a conceptual reference, constructed at the interface of inter-related concepts. The reference also contributed to the outlining of this qualitative research, which includes a questionnaire with ethical-pedagogical questions, sent to the coordinators of 15 courses selected for the sample. The results indicated a timely commitment of the courses to the ethical dimension of professional training, as well as advances in training of teaching staff, the profile of the graduate and the curricular integration process. On the other hand, they highlighted deficiencies regarding the contents concerned with the cultural, humanistic and political background in relation to didactic orientation, the teaching-learning scenarios, the evaluation process, and also the incipient presence of bioethics regarding the subject and the crossover curricular theme, together with the lack of specific training of the teaching staff.