Family Practice, 2023, XX, 1–9

https://doi.org/10.1093/fampra/cmad063
Systematic Review

Preferences for training needs of village doctors in China: a

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systematic review
Liying Zhou1,2,3,†, , Xuefeng Wei4,†, , Yanan Wu1,2,3, , Xinxin Deng1,2,3, , Meng Xu1,2,3, ,
Xue Shang1,2,3, , E. Fenfen1,2,3, , Guihang Song5, , Yiliang Zhu6, , Kehu Yang2,3, , Xiuxia Li1,2,3,*,
1
Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University,
Lanzhou, China
2
Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
3
Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
4
Health Commission of Gansu Province, Lanzhou, Gansu 730000, China
5
Gansu Healthcare Security Administration, Lanzhou, Gansu 730000, China
6
Department of Internal Medicine, The University of New Mexico, Albuquerque, NM 87131, United States
†Liying Zhou and Xuefeng Wei are co-first authors.
*Corresponding author: Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University,
199 Donggang West Road, Lanzhou 730000, China. E-mail: lixiuxia@lzu.edu.cn

Background: Village doctors, as gatekeepers of the health system for rural residents in China, are often confronted with adversity in providing
the basic public healthcare services.
Objective: We sought to summarize the training contents, training method, training location, and training costs most preferred by village doctors
in China and hope to provide evidence and support for the government to deliver better training in the future.
Methods: Eight databases were searched to include studies that reported on the training needs of village doctors in China. We undertook a
systematic review and a narrative synthesis of data.
Results: A total of 38 cross-sectional studies including 35,545 participants were included. In China, village doctors have extensive training
needs. “Clinical knowledge and skill” and “diagnosis and treatment of common disease” were the most preferred training content; “continuing
medical education” was the most preferred delivery method; above county- and county-level hospitals were the most desirable training loca-
tions, and the training costs were expected to be low or even free.
Conclusion: Village doctors in various regions of China have similar preferences for training. Thus, future training should focus more on the
training needs and preferences of village doctors.
Key words: healthcare workforce, primary healthcare, rural area, systematic review, training need, village doctor

Background complete care for rural residents from prevention to treat-

In 2009, the Chinese central government launched a new
phase of health reform. A major focus in this reform was on
providing all residents with equitable access to basic public
health services, including healthcare products and services
provided by health administrative authorities and medical
health institutions at all levels, to protect and promote public
health.1 In China, public healthcare services are delivered
through a 3-tiered system of village clinics, township hos-
pitals, and country hospitals. The major objectives of public
healthcare services were to increase the capacity of this system
to strengthen disease control and promote health and provide
a package of public healthcare services free of charge to all
residents.2
Primary healthcare workers include village doctors in vil-
lage clinics, township healthcare workers in rural township
healthcare centres, and community healthcare workers in
urban community healthcare centres.3 Village clinics are at
the bottom tier, and village doctors are the first line of contact
between patients and the healthcare system.4 They provide
ment to rehabilitation, and are responsible for 2-way referrals
between village clinics and higher-level hospitals.5 There are
approximately 1 million village doctors in China, many of
whom today are children, family members, or apprentices of
the internationally renowned barefoot doctors of the 1960s
and 1970s or previous barefoot doctors themselves.6 As
China transitioned to a Market-oriented economy in the late
1970s, the barefoot doctor system collapsed.6 In early 1980s,
the barefoot doctors were given the title of village doctors if
they could pass an examination.7 Many village doctors are
not officially considered doctors and are private practitioners
working in their own clinics, practicing a combination of
Western medicine and traditional Chinese medicine. The level
and quality of education of Chinese village doctors are highly
variable. Many village doctors have not achieved even a bach-
elor degree.8
Given the abovementioned factors, there are certain limi-
tations in the educational level, professional knowledge,
and capabilities of village doctors.9 Inadequate healthcare

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2 Training preferences

Key messages

• Village doctors in China exhibit a significant demand for training.

• Village doctors in China prefer training in “clinical knowledge and skill.”
• They also prefer training in “diagnosis and treatment of common disease.”

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• Village doctors in China prefer training through “continuing medical education.”
• They prefer training at above county- and country-level hospitals.
• Access to training for village doctors should be affordable, and ideally free.

service capacity in rural area has been a problem in China’s
healthcare system, directly leading to and aggravating the
difficulty and expenses in medical treatment.10 The team of
village doctors is still a weak link in China’s medical and
healthcare service system, and it is still difficult to fully meet
the growing needs of rural residents in terms of medical and
healthcare services with the knowledge and capabilities of vil-
lage doctors. A large number of research surveys have found
that there is still a need for training village doctors for various
skills, although China has been training barefoot doctors
since 1960s.11–14 In particular, with the current severely ageing
population of China; increasing incidence of chronic diseases,
infectious diseases, and public health emergencies; frequent
drug abuse; and higher requirements of the quality medical
services among rural residents, village doctors urgently need
to improve their skill set. Moreover, some studies have also
proved that the training work does not match the training
needs of village doctors.15,16
There is currently no systematic review of the training
needs of village doctors in China. Thus, to identify appro-
priate approaches for developing effective training measures
and better meet the training needs of village doctors, we
aimed to summarize the training preferences of village doc-
tors by systematically reviewing the literature.
Methods
Registration
The protocol was prospectively registered in the International
Prospective Register of Systematic Reviews (PROSPERO)
database on 26 August 2022 (registration number:
CRD42022353696).
Search strategy
We searched the Chinese National Knowledge Infrastructure
(CNKI), Chinese WanFang, Chongqing VIP electronic data-
bases, Chinese Biomedical Literature Database (CBM),
PubMed, The Cochrane Central Register of Controlled Trials
(CENTRAL), Web of Science, and EMBASE from the date
of their inceptions to 15 February 2023. We used the com-
bined method of MeSH Term and free words by searching
for the following keywords: (village OR rustic OR remote
OR barefoot OR grassroots OR underserved OR rural)
AND (health worker OR doctor OR physician OR general
practitioner OR clinician OR health provider OR nurse OR
health personnel OR health professional OR human re-
sources for health OR health workforce OR health man-
power OR health occupations manpower OR midwife) AND
(train OR education OR teach) AND (China OR Chinese).
The search strategy employed with PubMed is included in
Supplementary Text 1. The reference lists of the literature
identified through the abovementioned search strategy and
grey literature were collected to identify further studies.
Inclusion and exclusion criteria
Studies with the following criteria were included:
Participants: The subjects of the study were village doctors
in China.
Outcomes: The study outcomes were demand rates of
village doctors for various training content, training
methods, training location, and training cost.
Methods: No restrictions on study type.
The following studies were excluded: (i) studies investigated
the status or effectiveness of training; (ii) studies reporting
data that overlapped with already included studies; and (iii)
studies with incomplete data, letters, abstracts, reviews, and
protocols.
Literature selection and data extraction
Two reviewers screened the titles and abstracts of all retrieved
studies for relevance according to the inclusion and exclusion
criteria, and then scrutinized the full text of articles for which
the abstracts were identified as relevant or potentially rele-
vant. Each study was strictly evaluated against the inclusion
criteria and any disagreement in terms of study inclusion was
resolved by discussion with a reviewer.
Data were independently extracted in a standard form by
both reviewers. The extracts were compared, and any differ-
ences were verified and resolved through a discussion. The
extracts comprised information regarding general details
(title, authors, reference/source country, and year of publica-
tion), study details (study design, setting, eligibility criteria,
and sample size), participants (mean age, gender, and clinical
role), and results (response rate, outcome measures, primary
results, and author conclusions).
Risk of bias
Two reviewers independently assessed the quality of the studies
using the Joanna Briggs Institute (JBI) checklist for prevalence
studies.17 In summary, this tool rates the quality of selection,
measurement, and comparability of studies, covering 9 risk of
bias domains, as shown in Supplementary Text 2. However,
the JBI checklist does not provide an overall numerical score
for classifying studies based on quality. Accordingly, in this
review, we categorized the overall quality of the included
studies based on the following criteria according to a system-
atic review by Bhuvaraghan et al.18 for ease of understanding:
studies that were assessed as “Yes” on 8 or 9 domains, were
considered high quality (low risk of bias), those, assessed as
“Yes” on 6 or 7 domains were classified as moderate quality
Family Practice, 2023, Vol. XX, No. XX
(moderate risk of bias), and those assessed as “Yes” below 6
domains were considered low quality (high risk of bias).
Data synthesis
We tabulated the results from each study in detail to en-
able inspection and assessment of potential patterns within
the data. Given the substantial variation in survey content,
survey areas, and reported outcomes, we undertook narrative
synthesis of data, deeming formal quantitative meta-analysis
inappropriate.19–21 We extracted the preferences of village doc-
tors for different training contents, training methods, training
locations, and training costs in each study. In each study, the
training content, training location, training cost, and training
methods most needed by village doctors were counted, so as
to outline the village doctors’ preference for training.
Results
Selection of studies
As shown in Fig. 1, we identified 28,912 potentially rele-
vant publications after an initial search of 8 databases and
other sources (Google Scholar and review references). After
excluding of 11,365 duplicates, the titles and abstracts of
17,574 relevant publications were screened for eligibility and
a total of 589 articles were selected for full-text review. A
total of 551 articles were excluded because they did not meet
the inclusion/exclusion criteria. Finally, after applying all the
eligibility parameters, 38 articles11–16,22–53 were included for
qualitative analysis.
Characteristics of included studies
As shown in Table 1, among all the included literature, 37
studies were in Chinese and 1 in English. The mean age of the
participants was above 40 years in most studies. All included
studies were published between 2004 and 2021. The sample
sizes of the studies were between 55 and 18,259 individuals,
with a total of 35,545 individuals included across all studies.
Risk of bias
The quality assessment of our included studies is summarized
in Supplementary Table S1. Of the 38 studies assessed using
the JBI critical appraisal checklist for studies reporting preva-
lence data, 9 studies were judged as having a low risk of bias,
19 studies were judged as having a moderate risk of bias, and
10 studies were judged as having a high risk of bias.
Item 6 (the validity of the outcome measurement instru-
ment) and Item 7 (the reliability of measurement conducted)
were the domains that introduced the most bias. In addition,
Item 1 (the appropriateness of the sample frame), Item 2 (the
appropriateness of study participant recruitment), and Item 9
(the response rate) were the 3 domains frequently assessed as
contributing to a high risk of bias level in the included studies.
However, most studies reported Item 3 (the sample size), Item
4 (the description of study subjects and setting), Item 5 (the
coverage for subgroup sample size), and Item 8 (the appropri-
ateness of analytical strategy) accurately and were deemed to
have low/moderate risk of bias in terms of outcome reporting.
Narrative synthesis findings
All included studies reported that village doctors believed
they needed training. As shown in Supplementary Table S2,
we summarized 4 key results of Chinese studies, including
3
training content, training method, training location, and
training cost.
Training content In all, 27 articles11–14,16,22,23,25–41,45,49,51,53
surveyed the needs and preferences for training content for
village doctors in China. Of these, 11 studies pointed out that
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the training needs for the diagnosis and treatment of common
diseases ranked first, 8 studies pointed out that training needs
of clinical skills ranked first, 3 studies reported that training
needs of general medical knowledge ranked first, and 2 studies
reported that training needs for emergency first aid ranked
first. Three articles investigated the need for appropriate
traditional Chinese medicine techniques for training, of which
Dong’s acupoints in the treatment of lumbar disc herniation,
Ran’s Yiqitongjing points acupuncture in the treatment of
lumbar disc herniation, and acupuncture and moxibustion
omalgia burrow for the treatment of frozen shoulder were
considered to be the most appropriate traditional Chinese
medicine techniques for training.
Training method In all, 22 of included
articles11,16,23,25–28,30,33,36–45,47,48,51 investigated the needs of
village doctors for training methods. Of these, 7 studies
reported that the need for the training method of continuing
medical education ranked first, 4 reported that the need
for offline courses ranked first, 4 reported that the need for
guidance from senior doctors ranked first, 2 reported that the
need for training via lecture ranked first, 2 reported that the
need for remote/video training ranked first, 2 reported that
the need for a combination of lectures and guidance from
senior doctors ranked first, and 1 literature reported that the
need for self-education ranked first.
Training location A total of 16
articles16,18,23,25–28,30,36,38,39,41–43,46,48 investigated the preference
of village doctors for training locations, and the preferred
locations included county (n = 1), township healthcare centre
(n = 3), provincial or municipal hospital (n = 3), community
healthcare center (n = 1), medical school (n = 2), hospital (n
= 2), county hospital (n = 2), and county-level health training
institutions (n = 2).
Training cost A total of 7 articles11,15,26,29,30,32,36 investigated
village doctors’ needs for training costs. Three studies reported
that village doctors hoped that training was free, 1 study
reported that the average training cost expected by village
doctors was 198 CNY, 1 study reported that village doctors
hoped that the training cost was less than 400 CNY, and 2
studies reported that village doctors hoped that the training
cost was less than 500 CNY. Training expenses account for
approximately 5%–15% of the income of village doctors.
Discussion
All studies reported that village doctors in China believe they
need training. The reason for this may be that village doc-
tors thought that it was difficult to make accurate diagnoses
in day-to-day work, they could not understand the auxil-
iary test reports, they were often misunderstood by patients,
and they were not skilled in technical operations.11,25 To im-
prove the medical skillset, meet the needs of the job and the
requirements of healthcare departments, and improve the
level of preventive care, they felt it necessary to participate
in training.23,25,26 According to our narrative synthesis results,
“clinical knowledge and skill” (including the ability to make
4 Training preferences
Fig. 1. Flowchart of literature selection.
diagnosis and treatment of common diseases, knowledge and
skills for emergency medicine, diagnosis and differentiation of
infectious diseases, and rational drug usage) and “diagnosis
and treatment of common diseases” (including pneumonia,
chronic bronchitis, hypertension, gastroenteritis, tonsillitis,
and cold) were the most ideal training content. In summary,
we found that there is still an enormous training need for vil-
lage doctors for improving their professional medical capabil-
ities. This is likely due to the fact that a considerable number
of village doctors were formerly barefoot doctors who did not
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received a professional and systematic university education,
and their education was mainly limited to post-secondary
education.5 Furthermore, because of lack of attractiveness of
village doctor positions and poor retention, the current ser-
vice capacity of these village doctors cannot meet the health
needs of rural residents and the requirement of medical re-
form policies.25 In addition, operating income accounted for a
large proportion of the income of village doctors, unlike doc-
tors in township healthcare centres who have a higher basic
salary.34 Therefore, the village doctors wanted to increase
Family Practice, 2023, Vol. XX, No. XX 5

Table 1. Characteristics of included studies.

Author (year) Survey area Number of survey Age of survey Sex (M/F) of Response
participants participants survey participants rate (%)

Xiuhong Chen Pudong New Area, Shanghai 139 48.7 ± 12.5 52/87 100
(2018)

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Chuanlai A county in Anhui Province 343 40.42 290/53 92
Hu(2006)

Xuefeng Shi China 493 - - 100

(2012)

Shanggang Zong Henan Province 126 41.8 73/53 97.67

(2010)

Jing Sun (2014) Henan Province 365 43.01 ± 10.08 291/74 91.30

Jie Guo (2013) Hunan Province 270 47.4 ± 11.2 181/89 100

Shasha Fan Hunan Province 71 40.29 63/8 100

(2009)

Chuan Yang Yellow River Delta region 813 - 435/385 99.1

(2018)

Hongping Huang - 200 35.12 ± 5.33 113/87 100

(2019)

Wenli Jining City, Shandong Province 993 41.19 876/117 -

Zhang(2004)

Manling Liu Zhen’an County, Luoyang City, Shaanxi 229 46.06 170/59 100
(2021) Province

Bingzhi Hu Kashgar Prefecture, Xinjiang Uygur Au- 198 28.80 ± 7.01 12/186 90
(2017) tonomous Region

Xiaoyu Liang Kaifeng City, Henan Province 244 - 192/52 -

(2011)

Jiajin Hu (2016) Liaoning Province 1,183 40.95 582/601 78.90

Wei Meng (2018) Loufan County, Taiyuan City, Shanxi 80 39.9 26/54 100
Province

Zihan Meng Ningxia Hui Autonomous Region 107 40.96 77/30 97.29
(2016)

Zhenli Zhuang Baoshan City, Yunnan Province 2,799 - - 100

(2009)

Yifei Wang (2013) Ankang City, Shaanxi Province 55 - - 100

Jinwei Hu (2019) Shandong Province 330 43.8 ± 10.9 206/124 91.7

Chunxiang Yang Shanxi Province 177 45.9 151/26 88.50

(2009)

Min Sun (2008) Poor mountain area in Sichuan Province 91 39.65 61/30 100

Xiaorong Li Sichuan Province 230 - - 100

(2008)

Ying Wang (2015) Sichuan Province 177 45.64 129/48 96.72

Jun He (2009) Hebei Province Province, Yunnan Prov- 847 42.1 592/255 97.92
ince, Inner Mongolia Autonomous Region

Jia Yang (2014) China 108 47 - 100

Yingying Zhang China 1,658 41.56 1,023/635 81.96

(2019)
6 Training preferences

Table 1. Continued

Author (year) Survey area Number of survey Age of survey Sex (M/F) of Response
participants participants survey participants rate (%)

Yali Zhao (2010) Hebei Province Province, Shanxi Province, 142 33.5 ± 4.6 0/142 95.30
Inner Mongolia Autonomous Region

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Jian Gong (2011) Qiqihar City, Heilongjiang Province 228 41.26 189/39 100

Xianjun He China 165 41.38 112/53 100

(2004)

Weijuan Dai Jining City, Shandong Province 384 - - 96

(2015)

Jingzhi Chang Shangqiu City, Henan Province 356 - 181/175 100

(2015)

Yunjuan Chen Changzhou City, Jiangsu Province 213 37.63 55/158 100
(2005)

Jun He (2010) China 1,208 36.09 790/418 -

Rui Zhao (2019) Bengbu City, Anhui Province 98 48.5 63/35 95.15

Ling Zhou (2011) China 78 - - 100

Juyuan Liu China 18,259 44.3 ± 10.9 - 90.10

(2011)

Yunlan Zhang Chongqing 80 - - 100

(2010)

X.X. Zhan (2016) Hubei Province 2,008 45.44 1,460/548 92.30

-, not specified.

their income by undergoing training in clinical diagnosis and
treatment knowledge. In general, these factors together lead
to the enormous need for training in “clinical knowledge and
skill” and “diagnosis and treatment of common disease.”11,28,52
Several articles have reported that training on “appropriate
technology of traditional Chinese medicine,” “general med-
ical knowledge,” “emergency treatment,” “educational quali-
fications and practice certificate test training,” “appropriate
clinical skill,” and “occupational protection” were the most
needed among village doctors. However, compared with
studies in other countries,54–60 cross-sectional surveys in China
rarely report on the training needs for public health manage-
ment. This was a possible limitation of the understanding of
needs of village doctors in China, especially during the cur-
rent situation of the COVID-19 pandemic. China’s rural areas
are currently facing severe ageing far exceeding the national
level, with increasing incidences of chronic diseases, infec-
tious diseases, and public health emergencies, and frequent
drug abuse. Village doctors lack the corresponding medical
and public health knowledge to deal with these problems.
Therefore, the health management and public health know-
ledge levels of village doctors urgently need to be improved.
“Continuing medical education” was the most ideal de-
livery method compared with the offline courses, guidance
from senior doctors, combination of lectures and guidance
from senior doctors, lectures, remote/video education, and
self-education. The training method of “continuing medical
education” indicates that village doctors temporarily leave
their current jobs and go to designated professional training
institution (such as a hospital or a medical school) to receive
professional medical education for a period of time. Our
results showed that village doctors were more willing to ac-
cept professional and systematic offline education to improve
their practice, even if this was time consuming and took more
effort. Although online remote/video education is a fast and
convenient training method, it is not the training method
preferred by village doctors. However, these were the statis-
tical results of studies conducted before 2019, during which
period the surveyed provinces were mainly concentrated to
inland provinces with relatively underdeveloped economies in
China. Advances in information technology (IT) since then
have facilitated web-based education and have accelerated
knowledge delivery through the Internet. Moreover, in China,
the 4G network coverage rate exceeded 98% in 2022, making
online education accessible even in remote rural areas. In par-
ticular, after the outbreak of COVID-19, smartphones are
widely used in China, further facilitating online training.
Thus, an increasing number of people can use smartphones
smoothly and adapt to the Internet society. Particularly, vil-
lage doctors have mastered the use of smartphones for work,
given that all residents were required to use health codes and
travel codes after the outbreak of COVID-19. Therefore, on-
line remote/video education may be a more popular form of
training at present.53
Further, hospitals at the county level and above the
country level were the most desirable training locations.
This showed that village doctors had high expectations for
training and hoped to obtain higher-quality training. From
previous research results, we found that the main institu-
tions for training village doctors were township healthcare
centres. Township healthcare centres were helpful for vil-
lage doctors to participate in training. Village doctors
Family Practice, 2023, Vol. XX, No. XX
could participate in training without leaving the township,
which reduced conflicts between work and study and be-
tween family and study and saved training costs. However,
because of limitations in terms of training conditions and
resources, township centres cannot undertake the task of
training village doctors well. For example, the training ma-
terials and resources available to village doctors are often
outdated and insufficient, and the training programs may
not be well structured or well implemented. This may re-
sult in incomplete training and inadequate knowledge and
skills.33,41 In addition, because of contradictions in the man-
agement system, there was a certain unreasonable com-
petition between township healthcare centres and rural
doctors. Moreover, there was no perfect assessment mech-
anism for the responsibilities of the township healthcare
centres to train village doctors. All these abovementioned
reasons make township healthcare centres mediocre for the
implementation of continuing medical education for village
doctors.38,39,49,50 Thus, village doctors were more willing to
participate in training at institutions at a county level and
above.
Most village doctors hoped to avoid training fees. This was
mainly because of the low income of village doctors in China.
With the improvement of the economic level and the devel-
opment of transportation, rural residents are more willing to
go to township healthcare centres and county hospitals for
medical treatment. Thus, given the loss of the rural residents
and the increase in referral rates, the income of village doc-
tors also has gradually decreased.15,26 Therefore, village doc-
tors preferred to spend less or no money for completing the
training. Overall, China is a vast country with uneven devel-
opment among regions, and training needs can vary from city
to city. In addition, different ages groups, education levels,
and learning attitudes have an impact on training needs.
Therefore, before training is implemented, appropriate re-
search should be conducted on the training needs of a cer-
tain area in combination with previous research. The training
should be oriented based on the needs of regional healthcare
services and doctors.
Certainty of evidence
The overall quality of individual studies was low to mod-
erate. Seventy-four percent of studies were rated as mod-
erate or below. First, the main bias comes from the validity
of the questionnaire design and the reliability of the survey
implementation. This was because the design of the question-
naire, the quality assessment, and the survey process were not
strictly quality controlled or reported in detail, which may
cause certain measurement or survey bias. Second, many
studies were rated as high risk in terms of the appropriate-
ness of the sampling frame and the appropriateness of study
participant recruitment. The sampling frames of many studies
were not representative, and it was difficult to represent
their research subjects. Furthermore, the study participants
of many studies were recruited without random sampling or
detailed and complete reporting of the random sampling pro-
cess. However, it is worth noting that for sample size, coverage
of subgroup sample size, and response rate were mainly rated
as low risk. The sample size of surveys was adequate and had
a high response rate. This was mainly due to the help of the
Chinese government and healthcare department, which is a
huge advantage of conducting a medical survey in China.
7
Strengths and limitations
This study was guided by a predefined protocol. To the
best of our knowledge, this is the first systematic review
summarizing the training needs of village doctors in China.
Moreover, we conducted a robust, comprehensive, and re-
producible systematic search of 8 primary databases to in-
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clude all relevant studies. During screening, data extraction,
and risk of bias assessment, it was ensured that at least 2
researchers independently reviewed the data and differ-
ences, if any, were reasonably resolved by consulting a third
reviewer.
Meanwhile, some limitations of this study need to be
specified. First, some of the included studies reported were
more than 15 years old. This review included 10 studies con-
ducted before 2010, which had a certain influence on this
review. In China, it was stated in the National Educational
Planning for Rural Doctors (2001–2010) that by the end of
2010, at least 30% of rural doctors in areas with more devel-
oped economies and education levels should have obtained
healthcare education at the junior college level or above.
Further, in underdeveloped areas, more than 15% of rural
doctors should have obtained health education at the junior
college level or above. Therefore, the inclusion of studies be-
fore 2010 will have some impact on the results. Moreover,
with advancements in technology and the development of
society, the demand for training may also change. Second,
the content of questionnaires of the included studies differed,
which may have a certain impact on the evaluation of the re-
sults. Even for the same question, the options for some ques-
tionnaires greatly varied. Third, some studies surveyed small
areas (such as counties and villages) and the sample sizes of
these studies were small, resulting in low representativeness
of the results.
Conclusions
In China, village doctors have extensive training needs. In
our study, “Clinical knowledge and skill” and “diagnosis
and treatment of common disease” were the most preferred
training content; further, “continuing medical education”
was the most preferred delivery method; county-level hos-
pitals and above were the most desirable training locations;
and the training costs were expected to be low or even free.
Village doctors in various regions of China were found to
have similar preferences for training. Thus, future training
should focus more on training needs of village doctors as per
their preference. Compared with cities, rural areas should in-
crease research on the training needs of healthcare workers in
rural areas, because of their different geographical locations
and infrastructure, to provide support for the implementation
of training policies and further improve the policy impact on
rural areas.
Acknowledgements
Thanks to Shuya Ni, a master’s student from Jinan University,
for her help at various stages of this review.
Supplementary material
Supplementary material is available at Family Practice online.
8 Training preferences
Funding
This research is supported by the Adaptive Health Services
Training for Rural Chinese Village Doctors in the Loess
Plateau Gansu Province (Project No. SCH50020GR2040)
and Study on the Evaluation System of Health Insurance
Service Quality Based on DIP (Project No. YB2021B07).
Conflict of interest
None declared.
Ethical approval
Ethical approval was not required for this study.
Data availability
The data underlying this article are available in the article and
in its online supplementary material.
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