An ADDIE Model-Based Training Program for Enhancing Public Health Competencies in General Practice Residency:...

General practitioners (GPs) play a pivotal role in delivering public health services at the primary care level, yet standardized residency training often inadequately addresses public health competency development. This study aimed to systematically develop a public health service capability training course for GP residents using the ADDIE model and to preliminarily evaluate its effectiveness.

This study employed a non-randomized controlled trial design. A structured training program was developed following the five-phase ADDIE model. In the Analysis phase, competency gaps were identified through stakeholder needs assessment and literature review; in the Design phase, a 13-module curriculum was validated via two-round Delphi consensus (expert authority coefficient Cr = 0.921); in the Development phase, teaching materials, case libraries, and assessment tools were produced; the Implementation phase delivered the training through monthly 5-hour sessions over 13 months; and the Evaluation phase assessed outcomes using formative and phased assessments. The curriculum integrated case-based learning, problem-based learning, and simulation-based teaching. The intervention group (n = 32, 2023-2024 cohort) received the ADDIE-based training, while the control group (n = 22, 2021-2022 cohort) received conventional lecture-based training. Competencies were assessed at baseline, immediately post-training, and at 3-month follow-up, along with the annual Objective Structured Clinical Examination (OSCE, scored on a 100-point scale).

Within the intervention group (n= 32), formative assessment scores improved significantly from baseline to 3-month follow-up across all three domains (theoretical: 69.03 ± 6.65 to 84.59 ± 3.81; clinical: 67.40 ± 6.18 to 84.27 ± 3.30; practical: 74.78 ± 4.39 to 84.85 ± 3.76; all P < 0.001). For the phased assessment, the intervention group outperformed the historical control group (n = 22) on annual OSCE (71.88 ± 10.84 vs 62.07 ± 4.71; mean difference = 9.80, 95% CI: 4.29-15.29; P = 0.039; Cohen's d = 0.99), with greater improvement from baseline (Δ = 12.47 ± 4.27 vs 8.96 ± 3.51; P = 0.002; Cohen's d = 0.82). Course satisfaction was high (mean 4.43-4.83 on a 5-point scale).

The ADDIE-based training program demonstrated preliminary feasibility and potential effectiveness in enhancing GP residents' public health service competencies. However, as a single-center, non-randomized pilot study with a modest sample size, these findings should be interpreted cautiously.