Construction and Quality Appraisal of a TPKCEE-Based Community Teaching Program for General Practice Residency Training in Shanghai, China

Abstract

Background: General Practice Residency Training(GPRT) is one of the core links to consolidate the primary healthcare system and cultivate "gatekeepers" for residents' health. Primary healthcare puts forward higher requirements for the post competency of general practitioners(GPs). Mature training models are difficult to adapt to China due to the shortage of teachers, characteristics of primary healthcare and differences in patients' needs, and there is a lack of relevant local research in China. Therefore, it is urgent to construct a GPRT teaching program suitable for the primary care context of Shanghai.

Objective: To address the core pain points of "unstructured teaching resources" and "disconnection from community practice" in the GPRT in China, this study aimed to construct a community training program for GPRT based on the TPKCEE model, adapted to the primary care context of Shanghai, and to conduct a preliminary evaluation of its quality and feasibility.

Methods: In March 2025, a localized literature search was conducted to integrate policies and guidelines, such as "Healthy China 2030," with practical experience. A teaching program comprising six modules—Thinking (T), Problem (P), Key points (K), Case (C), Experiment (E), and Expansion (E)—was constructed, alongside a community implementation pathway developed based on the Structure-Process-Outcome (SPO) framework. Subsequently, a quality evaluation questionnaire was designed based on a modified AGREE-II framework. From July to August 2025, 15 senior general practice teaching experts were invited to participate in an anonymous consultation.

Results: The valid response rate of the expert consultation was 100%. The overall quality score for the teaching program was 6.13±0.64, and the score for the supporting cases was 6.09±0.74. The coefficient of variation (CV) for all indicators was < 0.25. In terms of promotion willingness, 46.7% (7/15) of experts said they were "willing to use it directly", 53.3% (8/15) said they were "willing to use it after modification", and no experts refused to use it. Delphi statistical indicators showed that the average authority coefficient (Cr) of experts was 0.88. Based on expert feedback, the research team completed five core revisions, including refining student grouping standards, emphasizing referral indications, and deepening the connotation of ideological education.

Conclusion: The community GPRT teaching program based on the TPKCEE model constructed in this study has good content validity and applicability in primary care. It provides a comprehensive and feasible operational tool to resolve the issue of insufficient integration between GPRT and the demand of the primary care system, possessing significant value for pilot trials and promotion in community teaching bases.

Keywords

General practice / Resident training / General practitioners / General medicine / Community health / Teaching research

Declarations

Not applicable.

Authors' contributions

Conceptualization, Z.H.; Methodology, Z.H.; Data curation, Z.H., Y.S., Z.Y., W.Y., S.H. and H.R.; Formal analysis, Z.H., Y.S., Z.Y., W.Y., S.H. and H.R.; Funding acquisition, not applicable; Project administration, not applicable; Resources, T.W.; Supervision, J.S.; Validation, Y.D.; Writing—original draft, Z.H.; Writing—review and editing, Y.D. All authors have read and agreed to the published version of the manuscript.

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Declaration of competing interest

Y.D. is the Academic Advisory Committee Member of CGPJ, but he is not responsible for the review of the manuscript. All authors declare that there are no competing interests.

Acknowledgements

Not applicable.

Supplementary materials

Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.cgpj.2026.100098.

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