背景:中国政府制定了一系列政策,并加强了对全科医生(GP)的培训,以支持他们作为居民健康的“看门人”。本研究旨在探索中国全科医生的核心能力,并制定符合中国国情的能力框架。这可以为教育提供更科学的基础,培训,和GP的评估。
方法:进行文献分析和行为事件访谈,以建立胜任力词典和胜任力模型的初始版本。进行了两轮Delphi,以获得对最终模型的共识。问卷调查在10个省(市、自治区)中国,并邀请全科医生对每个能力项目的重要性进行评分。将总样本随机分为两组。一组是探索性因素分析(EFA),另一个是验证性因子分析(CFA)来检验量表的信度和效度。
结果:构建了包括107个能力项目的全科医生能力词典。经过两轮德尔福,就6个领域的60项能力达成共识。全国调查共获得有效问卷1917份。所有二级指标的平均重要性评分为4.53±0.45。Cronbach'sα系数为0.984。通过EFA提取的五个因子显示68.16%的累积解释方差变化的结果被认为与Delphi获得的六个维度一致。CFA获得的模型适应度指标可接受(χ2/df=4.909,CFI=0.869,NFI=0.841,RMSEA=0.065)。六个维度的复合可靠度(CR)值均大于0.7(0.943,0.927,0.937,0.927,0.943,0.950),提取的方差平均值(AVE)均大于0.5(0.562、0.613、0.649、0.563、0.626、0.635)。结果表明,该模型具有良好的信度和效度。
结论:已经建立了适合中国的全科医生胜任力模型,这可能为全科医生未来的培训和医疗执照考试提供指导。
BACKGROUND: The Chinese government has formulated a series of policies and strengthened training of general practitioners (GPs) to support their role as \"gatekeepers\" of residents\' health. This
study aimed to explore the core competencies of Chinese GPs and develop a
competency framework in line with China\'s actual conditions, which can provide a more scientific basis for the education, training, and evaluation of GPs.
METHODS: Literature analysis and behaviour event interviews were conducted to build the
competency dictionary and the initial version of the
competency model. Two rounds of Delphi were performed to gain consensus on the final model. The questionnaire survey was carried out in 10 provinces (municipalities, autonomous regions) of China, and GPs were invited to score the importance of each competency item. The total sample was randomly divided into two groups. One group was for exploratory factor analysis (EFA), and the other was for confirmatory factor analysis (CFA) to examine the scale\'s reliability and validity.
RESULTS: The dictionary of general practitioners\'
competency including 107
competency items was constructed. After two rounds of Delphi, a consensus was reached on 60 competencies in 6 domains. A total of 1917 valid questionnaires were obtained in the nationwide survey. The average importance score of all second-level indicators is 4.53 ± 0.45. The Cronbach\'s α coefficient is 0.984. The results of the five factors extracted by EFA showing the 68.16% cumulative explained variance variation is considered to be consistent with the six dimensions obtained by Delphi after thorough discussion. The model fitness indexes obtained by CFA were acceptable (χ2/df = 4.909, CFI = 0.869, NFI = 0.841, RMSEA = 0.065). The values of the composite reliability (CR) of the six dimensions were all greater than 0.7 (0.943, 0.927, 0.937, 0.927, 0.943, 0.950), and the average of variance extracted (AVE) were all greater than 0.5 (0.562, 0.613, 0.649, 0.563, 0.626, 0.635). The results showed that the model has good reliability and validity.
CONCLUSIONS: A
competency model for GPs suited to China has been developed, which may offer guidance for future training and medical licensing examinations of GPs.