Evaluation of the Spring Seedling Project-Zhaotong Program: A study of a novel continuing medical education program for rural doctors in China

Aust J Rural Health. 2020 Oct;28(5):434-442. doi: 10.1111/ajr.12659. Epub 2020 Sep 27.


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.

Keywords: GP; continuing medical education; program evaluation; remote and rural education; rural.

MeSH terms

  • Adult
  • China
  • Clinical Competence
  • Education, Medical, Continuing*
  • Family Practice / education
  • Female
  • Humans
  • Male
  • Middle Aged
  • Program Evaluation*
  • Rural Health Services*