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Association Between External Training and Self-Reported Competence Improvement Among County Hospital Healthcare
Siyi Hu1, Penghao Fan2, Siyuan Zhang1
1School of Humanities and Management, Zhejiang Chinese Medical University, 260 Baichuan Street, Hangzhou 311400, China.
Healthcare (Basel, Switzerland)
|August 13, 2026
Summary
External training significantly improved healthcare provider competence in China's county hospitals. Policy awareness further amplified these positive effects, highlighting the importance of targeted support and dissemination.
Area of Science:
- Healthcare Management
- Medical Education
- Public Health Policy
Background:
- Healthcare provider training is linked to improved competence.
- China's "Thousand-County Project" policy aimed to enhance county hospital capabilities.
- This study investigated external training's impact on competence within this policy context.
Purpose of the Study:
- To evaluate the association between external training and self-reported competence improvement.
- To assess the role of policy awareness in this relationship.
- To provide evidence-based recommendations for improving healthcare provider training initiatives.
Main Methods:
- A multi-center cross-sectional survey of 605 healthcare providers in 30 county hospitals across China.
- Propensity score matching to control for confounding variables.
- Multivariable ordinal logistic regression to analyze the association between training and competence improvement.
Main Results:
- Healthcare providers receiving external training reported significantly higher competence improvement (OR = 3.36).
- Policy awareness was strongly associated with competence improvement (OR = 4.50).
- The positive effect of training was amplified among providers aware of the policy (p for interaction = 0.043).
Conclusions:
- Post-policy external training is a key driver of competence improvement in county hospitals.
- Enhancing policy awareness strengthens the impact of training initiatives.
- Recommendations include increased financial support for training, optimized hospital staffing, and improved policy dissemination.