Training needs and influencing factors among rural-oriented general practitioners in Chongqing, China: a cross-sectional survey and latent profile analysis

TL;DR

This study identifies training needs and influencing factors among rural doctors in Chongqing, China, to improve their retention and healthcare quality.

Contribution

The study introduces a tiered CME framework based on latent profile analysis to address rural GPs' training needs and retention.

Findings

Rural GPs showed significant training needs across 37 skills, with the highest demand in Clinical Research and Evidence-Based Practice.

Three subgroups of training needs were identified: low (46.46%), medium (41.14%), and high (12.40%).

Higher income and professional titles were linked to lower training needs, while having one child increased training demand.

Abstract

Rural-oriented General Practitioners (GPs) are a key workforce to alleviate physician shortages in central and western China and improve the quality of primary healthcare services. However, they currently face high attrition rates. Targeted and effective continuing medical education (CME) can partially improve their retention rates. Nevertheless, existing CME programs do not align with these GPs’ practical needs. This study aims to assess these GPs’ CME needs and associated influencing factors, providing evidence-based support for the development of CME curricula and related policy formulation.

A cross-sectional survey was conducted via stratified sampling among 508 rural-oriented GPs across 38 counties of Chongqing from July to August 2025. Data were collected using the Chinese-validated version of the Hennessy-Hicks Training Needs Analysis Questionnaire, which had been translated and validated before implementation, and a researcher-designed general information questionnaire. The questionnaires covered basic demographics, perceived importance of professional skills, and self-rated proficiency scores. Descriptive statistics and comparative analysis were used to identify the overall priority training needs. Latent profile analysis was employed to identify the types of training needs, and multinomial logistic regression analysis was conducted to identify factors influencing training needs.

Rural-oriented GPs reported significant training needs across all 37 skills (p < 0.001). The most pronounced demand was observed in the Clinical Research and Evidence-Based Practice dimension (Mean difference 1.60, 95% CI: 1.49–1.72). Latent profile analysis identified three subgroups: low demand (46.46%), medium demand (41.14%), and high demand (12.40%). Logistic regression analysis showed that higher professional titles, higher monthly income, and engagement in research were associated with lower training needs, while having one child (compared to having no children) was associated with higher training needs.

Training demands show heterogeneity across subgroups among rural-oriented GPs in Chongqing and are affected by multiple factors. A significant training gap exists with the most urgent need in Clinical Research and Evidence-Based Practice. A tiered, demand-driven CME system should be established, prioritizing the development of research course modules. This should be combined with mechanisms for professional title promotion and salary incentives, providing flexible learning options to enhance career prospects and retention. This study also provides a research framework that can be adapted in other regions and countries where such experience is scarce.

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