关键词: 全科医生, 能力评价, 指标体系, TSH模型, 德尔菲法

Abstract: Background　The development of general practitioners'（GPs'） competence assessment systems has become mature in foreign countries. However，in China，GPs' competence has been assessed mainly by healthcare institutions themselves. Due to different standards and evaluation methods of various institutions，the authority and objectivity of the assessment results cannot be guaranteed. Therefore，it is necessary to establish a unified standard in line with the current development of general practice. Objective　To develop a tiered GPs' competence assessment system using the Delphi method，and based on this，to develop a theory-skill-humanity（TSH） cube model，to improve the GPs' competence assessment more accurately and objectively via promoting the homogenous progress. Methods　From April to May 2019，using literature review and group discussion，we developed a preliminary framework of a three-tiered GPs' competence assessment system consisting of 3 first-tier indices（general practice theory，skills and humanity），44 second-tier indices and 44 third-tier indices. Then we developed the GPs' competence assessment system after revising the framework according to the results analysis data of a two-round Delphi survey with 28 experts conducted from July 1 to September 10，2019. We analyzed the experts' basic personal information，suggestions for the framework，and their positive，authoritative and Kendall's concordance coefficients as well as consensus level in the survey. Results　The familiarity and judgment coefficients were 0.900 and 0.936，respectively，in the first round of survey，and were 0.948 and 0.952，respectively，in the second round.The authority coefficient in the first and second round expert consultation was 0.918 and 0.952，respectively，which were both above 0.70. The importance and accessibility coefficients were 0.471 and 0.409，respectively，for the first round of survey，and were 0.363 and 0.386，respectively，for the second round. The final GPs' competence assessment system includes three domains（general practice theory，clinical skills and humanity），and 43 assessment items. In accordance with this system and previous patents，the TSH model was developed.Conclusion　 Our GPs lusmpetence assessment system developed based on the results of email-based surveys with high expertsent sytive and authoritative coefficients and consensus，includes three first-tier indices，43 second-tier indices and 43 third-tier indices，which is scientific，reliable and reliable verified statistically.

Key words: General practitioners；Theoretical examination；Indicators system；TSH（theory, skill, humanity）model；Delphi method