To develop and verify a competency evaluation system for general practice team leaders, providing a reference for scientifically assessing the competencies of a general practice team leader, and for selecting an eligible person as a general practice team leader.

By use of literature review and semi-structured reviews, we collected data regarding competencies for an eligible general practice team leader, and used them to initially develop a competency evaluation system for general practice team leaders. Then from July to October 2020, we conducted a three-round Delphi survey with a purposive sample of 20 experts (in the field of general medicine, medical education, public health management, or administrative management) to improve the system, and assess the indicators of the system using the analytic hierarchy process, and test the logic consistency among indicators, then the final system was formed. To assess values of the three-level indicators in the system, from November 1 to 30, 2020, we carried out a survey on wjx.cn (an online questionnaire survey platform) using a self-administered questionnaire developed by us, and selected a stratified random sample of 32 cases (16 directors of community health centers, and 16 general practice team leaders from 8 central urban districts of Shanghai) to anonymously complete the survey via scanning the WeChat RQ code using a mobile phone or computer. The survey data were collected to input into a database, and analyzed for understanding the inter-rater differences in the importance of the top 15 indicators.

The response rate, authority coefficient, and Kendall's W were 90.0%, 0.912, and 0.183 (χ²=42.516, P<0.001) respectively, for the first round of survey, 95.0%, 0.933, and 0.359 (χ²=68.937, P<0.001) respectively, for the second round of survey, and 100.0%, 0.940, and 0.516 (χ²=87.329, P<0.001) , respectively, for the third round of survey. The final system is composed of 5 first-level indicators, 17 second-level indicators and 43 third-level indicators. The weights for the 5 first-level indicators were 0.344, 0.222, 0.192, 0.137 and 0.105, respectively. The consistency ratios for hierarchical arrangement of indicators were all <0.1. Among the top 15 third-level indicators in terms of importance, except for the importance of "the ability to provide referral services", and "the ability to assist in the handling and management of public health events", the importance of other 13 indicators rated by directors of community health centers and general practice team leaders showed no significant differences (P>0.05) .

The system developed by us has high scientificity and practicability with a rational structure and well-targeted indictors, which may be used as a tool for the selection and training of general practice team leader.