RESUMO
OBJECTIVE: To evaluate the effectiveness of the Spring Seedling Project-Zhaotong program, a novel continuing medical education program, to improve the knowledge and skills of rural doctors in China. DESIGN: An uncontrolled single-group pre- and post-intervention design based on quantitative and qualitative methods. SETTING: Zhaotong is a prefecture-level city located in Yunnan, China. PARTICIPANTS: A total of 1866 country doctors practising in Zhaotong were enrolled. INTERVENTIONS: The Zhaotong program consisted of three stages: remote education, workshops conducted in Zhaotong and field training in Shanghai. MAIN OUTCOME MEASURES: The effectiveness of the remote education and Zhaotong workshop stages was assessed based on differences between pre- and post-training test scores. Qualitative comments were collected to assess the experience of country doctors following the Shanghai field training stage. RESULTS: In total, 1866 country doctors (46.9% males; mean age: 38.2 ± 9.2 years) participated in the program. The average score of the post-training test was higher than that of the pre-training test, both online (P < .001) and offline (P < .001). In regard to the Zhaotong workshops, with the exception of incisions/suturing, the average scores of cardiopulmonary resuscitation, gynaecological examinations and child growth/development were improved after training (P < .001). Qualitative analysis showed that Shanghai field training enhanced understanding of general practice, with the majority of country doctors indicating that they would apply what they learned in daily practice. CONCLUSION: This study introduced an comprehensive form of continuing medical education for rural doctors in Zhaotong and proved the effectiveness of this program and also provided a reference point for the future development of continuing medical education.