General practitioners (GPs) play a major role in providing essential medical services. Most of the existing research on GPs' competencies emphasizes that efforts should be made to improve the medical knowledge and skills of GPs, ignoring the importance of their inner competencies. And there is no scale for effective measurement of GPs' inner competencies in China. Thus, developing a assessment scale of GPs' inner competencies is of great significance for improving the quality of essential medical services.

To develop an inner competency rating scale for GPs and to assess its psychometric properties, providing certain reference for improving GPs' competencies.

By use of literature review and behavioral event interviews results, the draft of the General Practitioner Inner Competency Rating Scale (GPICRS) was developed. Then in September to December 2021, the draft was tested by a survey with a national random sample of 380 (88.2%) GPs. Its rationality was verified by item purification, exploratory factor analysis, confirmatory factor analysis and reliability and validity tests. The weighted average method was used to evaluate the inner competency of GPs. The total and dimensions scores of the GPICRS were compared by demographics.

Three hundred and thirty-five GPs who returned responsive questionnaires were included for analysis. The formal scale consists of 14 items in 4 dimensions: work motivation, self-efficacy, medical humanities and professional qualities. The value of KMO (0.737) and result of Bartlett's Test of Sphericity (χ²=592.715, P<0.001) derived from the exploratory factor analysis, suggested that the data sample was appropriate for factor analysis. Four common factors with an eigenvalue >1.000 were extracted, and the percent of total variance explained by which was 58.861%. The results of confirmatory factor analysis showed that the fitting indicators of the four-factor model were acceptable (χ²/df=2.834, RMSEA=0.074, GFI=0.922, PGFI=0.623, NFI=0.889, TLI=0.903, CFI=0.924) . When it comes to the formal scale, the Cronbach's α was 0.851. The Cronbach's α for each of its dimensions ranged from 0.757 to 0.809. The standardized regression coefficient of each item was greater than 0.500, and the AVE for each dimension was above 0.500. And the CR value for each dimension was greater than 0.700. The arithmetic square root of AVE was greater than the correlation coefficient between the factors. The average total GPICRS score of the 335 GPs was 4.15, which was at a good level, and GPICRS score varied across GPs by different characteristics (gender, age group, professional title, etc.) .

Our GPICRS could effectively evaluate the inner competency of GPs, which may contribute to the decision-making in primary care and the personal development of GPs. In the future, efforts can be made to improve the comprehensive capability of GPs from the following four aspects: self-cognition and occupational identity, theoretical knowledge and practical application, professional ability and work attitude, organizational support and social recognition.

全科医生是基层医疗服务的"主力军"，现有关于全科医生胜任力的研究大部分强调应着力提升全科医生的知识和技能水平，忽略了全科医生内隐素质的重要性。目前我国仍缺乏评估全科医生内隐胜任力的有效工具，开发全科医生内隐胜任力量表（GPICRS）对于提高基层医疗服务质量具有重要意义。

编制GPICRS，并对其进行评价，旨在为提升全科医生胜任力提供一定的参考。

在文献分析和行为事件访谈的基础上，形成初始版量表。于2021年9—12月，采用随机抽样法，从全国选取380例全科医生为研究对象，采用初始版GPICRS对其进行调查，通过项目净化、探索性因子分析、验证性因子分析、信效度分析验证量表的合理性，基于加权平均法评价全科医生的内隐胜任力水平，比较不同特征全科医生的GPICRS平均总得分及各维度得分。

共回收有效问卷335份（88.2%）。GPICRS由工作动机、自我效能感、医学人文关怀和医学职业素养4个维度14个条目构成。探索性因子分析结果显示，KMO值为0.737，Bartlett's球形检验χ²=592.715、P<0.001，表明数据适合进行因子分析；按特征根>1.000的标准可提取4个公因子，公因子的累积方差贡献率为58.861%。验证性因子分析结果显示，四因子模型各拟合指标处于可接受范围〔χ²/df=2.834，近似误差均方根（RMSEA）为0.074，拟合优度指数（GFI）为0.922，简约拟合优度指数（PGFI）为0.623，规范拟合指数（NFI）为0.889，非归准适配指数（TLI）为0.903，比较拟合指数（CFI）为0.924〕。量表的Cronbach's α系数为0.851，各维度的Cronbach's α系数为0.757~0.809；各条目的标准化因子载荷系数均>0.500，各维度的平均提取方差值（AVE）均>0.500，各维度的组合信度（CR）值均>0.700；各维度AVE的平方根均大于其与其他维度之间的相关系数。基于加权平均法，335例全科医生的GPICRS平均总得分为4.15分，处于良好水平，且不同特征（性别、年龄组别、职称等）全科医生的GPICRS平均总得分及各维度得分存在差异。

本研究开发的GPICRS能有效评估全科医生胜任力水平，可为基层医疗卫生机构决策及全科医生个人发展提供一定的参考。未来可从自我认知与工作认同、理论知识与实践应用、业务能力与工作态度、组织支持与社会认可四方面着力提升全科医生综合能力。