Construction of Competency Model for Chinese Assistant General Practitioners Based on Delphi and Analytic Hierarchy Process

doi:10.12114/j.issn.1007-9572.2023.0205

Chinese General Practice ›› 2024, Vol. 27 ›› Issue (31): 3946-3952.DOI: 10.12114/j.issn.1007-9572.2023.0205

Special Issue: 全科医生最新文章合辑；全科医学教育专题研究

• Article·Focus on General Practice Education • Previous Articles Next Articles

Construction of Competency Model for Chinese Assistant General Practitioners Based on Delphi and Analytic Hierarchy Process

1. Department of General Medicine, the First Hospital of China Medical University, Shenyang 110000, China
2. Department of Science and Education, Chaoyang Central Hospital, Chaoyang 122000, China
3. China Medical University Library, Shenyang 110000, China
4. The Fourth Affiliated Hospital of China Medical University, Shenyang 110000, China
5. School of Public Health, Jinzhou Medical University, Jinzhou 121000, China
6. Science and Technology Department, Dalian Medical University, Dalian 116000, China

Received:2023-12-28 Revised:2024-07-03 Published:2024-11-05 Online:2024-08-16
Contact: YU Xiaosong

基于德尔菲法和层次分析法的中国助理全科医生岗位胜任力模型构建研究

1．110000　辽宁省沈阳市，中国医科大学附属第一医院全科医学科
2．122000　辽宁省朝阳市中心医院科教科
3．110000　辽宁省沈阳市，中国医科大学图书馆
4．110000　辽宁省沈阳市，中国医科大学附属第四医院
5．121000　辽宁省锦州市，锦州医科大学公共卫生学院
6．116000　辽宁省大连市，大连医科大学科技处

通讯作者: 于晓松
作者简介:
作者贡献：
张旭提出主要研究目标，负责研究的构思与设计，研究的实施，撰写论文；张旭、宫雪、徐沙沙、张鑫岩、李一萱进行数据的收集与整理，统计学处理，图、表的绘制与展示；于晓松负责文章的质量控制与审查，对文章整体负责，监督管理。
基金资助:
国家医学考试中心项目(222-2100019002)

Abstract

Abstract:

Background

As an important part of the general practice team, assistant general practitioners undertake a lot of grassroots general practice work, but at present, there is no recognized national level assistant general practitioners post competency model to provide scientific basis for training qualified assistant general practitioners.

Objective

The competency of assistant general practitioners for China was constructed to provide support for the design of national assistant physician qualification examination, and provide theoretical basis for the training and evaluation of assistant general practitioners.

Methods

Based on the research group's previous literature research and behavioral event interviews, from September 2019 to January 2020, the entry pool was established, and 30 experts engaged in general practice were consulted by Delphi method for 2 rounds. The index and weight coefficient of the Chinese assistant general practitioner post competency model were determined by AHP.

Results

Six first-level indicators [the basic medical and health services (0.244 8), medical knowledge and life-long learning (0.244 8), and professional quality (0.244 8), interpersonal communication and team work (0.138 9), the basic public health services (0.085 8), the information utilization ability and management capacity (0.041 0) ] and 63 second-level indicators were finalized, and the weight coefficients of each indicator were defined.

Conclusion

This study constructs the post competency of assistant general practitioners for China for the first time, which has a high degree of expert representativeness and authority, and a more comprehensive and reasonable index selection, laying a foundation for the empirical study of the index system.

Key words: General practitioners, Assistant general practitioners, Competency, Delphi method

摘要：

背景

助理全科医生是全科医生队伍的重要组成部分，承担着许多基层全科工作，但目前国内还没有公认的国家层面助理全科医生岗位胜任力模型为培养合格的助理全科医生提供科学的依据。

目的

构建中国助理全科医生岗位胜任力模型指标体系，为国家助理医师执业资格考试设计的完善提供支持，同时为助理全科医生的培养和评价提供理论依据。

方法

基于课题组前期文献研究和行为事件访谈建立条目池，于2019年9月—2020年1月采用德尔菲法对30位从事全科医学领域的专家进行2轮咨询，运用层次分析法确定中国助理全科医生岗位胜任力模型指标及权重系数。

结果

最终拟定中国助理全科医生岗位胜任力一级指标6个[基本医疗卫生服务（0.244 8）、医学知识与终身学习（0.244 8）、职业素养（0.244 8）、人际沟通与团队合作（0.138 9）、基本公共卫生服务（0.085 8）、信息利用能力与管理能力（0.041 0）]，二级指标63个，并明确了各个指标的权重系数。

结论

本研究首次构建了中国助理全科医生岗位胜任力模型，其专家代表性及权威程度较高，指标筛选较为全面、合理，为指标体系的实证研究奠定了基础。

关键词: 全科医生, 助理全科医生, 胜任力, 德尔菲法

ZHANG Xu,GONG Xue,XU Shasha, et al. Construction of Competency Model for Chinese Assistant General Practitioners Based on Delphi and Analytic Hierarchy Process[J]. Chinese General Practice, 2024, 27(31): 3946-3952. DOI: 10.12114/j.issn.1007-9572.2023.0205.
张旭,宫雪,徐沙沙等. 基于德尔菲法和层次分析法的中国助理全科医生岗位胜任力模型构建研究[J]. 中国全科医学, 2024, 27(31): 3946-3952. DOI: 10.12114/j.issn.1007-9572.2023.0205.

Figures/Tables 3

References 24

[1]	LIAN S Q, CHEN Q, YAO M, et al. Training pathways to working as a general practitioner in China[J]. Family Medicine，2019，51(3):262-270.
[2]	原卫计委.国家卫生计生委科技教育司负责人就印发《助理全科医生培训实施意见（试行）》答记者问[EB/OL]. (2016-06-14)[2023-12-01].
[3]	张旭. 中国助理全科医生岗位胜任力模型构建研究[D]. 沈阳：中国医科大学，2021.
[4]	沈曙红. 面向乡村助理全科医生人才培养协同育人机制改革的探索与实践[J]. 中国职业技术教育，2019(16):56-60.
[5]	培养有"胜任力"的全科医生[EB/OL]. (2015-04-07)[2023-05-20].
[6]	WONCA EUROPE. The European definition of general practice[EB/OL].[2023-12-14].
[7]	The CanMEDS 2005 physician competency framework[EB/OL].[2023-12-14].
[8]	WITTELES R M, VERGHESE A. Accreditation council for graduate medical education（ACGME）milestones-time for a revolt？[J]. JAMA Internal Medicine，2016，176(11):1599-1600.
[9]	LONGENECKER R L, WENDLING A, HOLLANDER-RODRIGUEZ J, et al. Competence Revisited in a Rural Context[J]. Fam Med，2018，50(1):28-36.
[10]	O'SULLIVAN D, AND D R, YOUNG S. A Framework for the use of competencies in rural social work field practice placements[J].Australian Social Work，1997，50(1):31-38.
[11]	张莉，单楠，马玲，等. 德尔菲法在助理全科医师岗位胜任力指标体系构建中的应用[J]. 中国初级卫生保健，2019，33(6):12-14.
[12]	徐英姿，黄武全，翟佳燚，等. 基于岗位胜任力的上海市家庭医生助理岗位准入指标体系构建研究[J]. 中国全科医学，2020，23(28):3569-3575.
[13]	张旭，宫雪，李一萱，等. 助理全科医生岗位胜任力的初步研究[J]. 中华全科医生杂志，2021，20(3):327-331.
[14]	（美）艾尔·巴比.邱泽奇译. 社会研究方法[M]. 北京：华夏出版社，2000.
[15]	曾光.现代流行病学方法与应用[M]. 北京：北京医科大学、中国协和医科大学联合出版社，1994.
[16]	关勋强，李瑞兴，刘运成. 医学研究生教育评价研究与实践[M]. 北京：军事医学科学出版社，2000.
[17]	曹茂林. 层次分析法确定评价指标权重及Excel计算[J]. 江苏科技信息，2012(2):39-40.
[18]	刘晓红，何仲. 德尔菲法在护理研究中的应用[J]. 中华护理教育，2005，2(1):6-8.
[19]	杜栋，庞庆华，吴炎. 现代综合评价方法与案例精选[M]. 2版. 北京：清华大学出版社，2008.
[20]	王晶.全科医生岗位胜任力模型构建与实证研究[D]. 太原：山西医科大学，2016.
[21]	SCHERGER J E. Preparing the personal physician for practice（P（4））：essential skills for new family physicians and how residency programs may provide them[J]. J Am Board Fam Med Jabfm，2007，20(4):348-355.
[22]	MORLEY C P, ROSAS S R, MISHORI R, et al. Essential public health competencies for medical students：Establishing a consensus in family medicine[J]. Teach Learn Med，2017，29(3):255-267.
[23]	LIN I B, BEATTIE N, SPITZ S, et al. Developing competencies for remote and rural senior allied health professionals in Western Australia[J]. Rural Remote Health，2009，9(2):1115.
[24]	宫雪. 中国全科医生岗位胜任力指标体系构建研究[D]. 沈阳：中国医科大学，2022.

变量	第一轮（n=25）		第二轮（n=23）
变量	人数	百分比（%）	人数	百分比（%）
性别
男	9	36.00	8	34.78
女	16	64.00	15	65.22
年龄
35~45岁	12	48.00	12	52.17
46~55岁	8	32.00	7	30.43
>55岁	5	20.00	4	17.39
学历
博士	10	40.00	9	39.13
硕士	8	32.00	7	30.43
本科	7	28.00	7	30.43
职务
全科住培基地主任	1	4.00	1	4.35
社区全科医生	7	28.00	6	26.08
全科医学教育专家	2	8.00	1	4.35
综合医院全科医生	15	60.00	15	65.22
职称
正高	15	60.00	13	56.52
副高	8	32.00	8	34.78
中级	2	8.00	2	8.70
初级	0	0	0	0
区域
东部	11	44.00	9	39.13
中部	7	28.00	7	30.43
西部	7	28.00	7	30.43
工作年限
10~20年	11	44.00	10	43.48
21~30年	9	36.00	8	34.78
>30年	5	20.00	5	21.74
全科相关工作年限
≤10年	14	56.00	14	60.87
11~20年	8	32.00	7	30.43
>20年	3	12.00	2	8.70

变量	第一轮（n=25）		第二轮（n=23）
变量	人数	百分比（%）	人数	百分比（%）
性别
男	9	36.00	8	34.78
女	16	64.00	15	65.22
年龄
35~45岁	12	48.00	12	52.17
46~55岁	8	32.00	7	30.43
>55岁	5	20.00	4	17.39
学历
博士	10	40.00	9	39.13
硕士	8	32.00	7	30.43
本科	7	28.00	7	30.43
职务
全科住培基地主任	1	4.00	1	4.35
社区全科医生	7	28.00	6	26.08
全科医学教育专家	2	8.00	1	4.35
综合医院全科医生	15	60.00	15	65.22
职称
正高	15	60.00	13	56.52
副高	8	32.00	8	34.78
中级	2	8.00	2	8.70
初级	0	0	0	0
区域
东部	11	44.00	9	39.13
中部	7	28.00	7	30.43
西部	7	28.00	7	30.43
工作年限
10~20年	11	44.00	10	43.48
21~30年	9	36.00	8	34.78
>30年	5	20.00	5	21.74
全科相关工作年限
≤10年	14	56.00	14	60.87
11~20年	8	32.00	7	30.43
>20年	3	12.00	2	8.70

专家咨询	ω	df	χ²值	P值
第一轮	0.368	86	792.098	<0.001
第二轮	0.345	68	540.003	<0.001

专家咨询	ω	df	χ²值	P值
第一轮	0.368	86	792.098	<0.001
第二轮	0.345	68	540.003	<0.001

一级指标	权重系数	二级指标	权重系数
A基本医疗卫生服务	0.244 8	A1全科医生临床思维	0.14
		A2病史采集	0.11
		A3体格检查与精神状态检查	0.11
		A4辅助检查项目选择与结果解读	0.06
		A5常规诊疗操作技术	0.04
		A6常见病、多发病的诊疗	0.11
		A7医疗文书及病历书写	0.08
		A8转诊能力	0.03
		A9常见社区急症处理及现场急救	0.08
		A10合理用药	0.14
		A11临终关怀	0.02
		A12以家庭为单位的照顾	0.03
		A13健康管理与慢病管理	0.04
B基本公共卫生服务	0.085 8	B1传染病的防控	0.14
		B2健康教育与健康促进	0.22
		B3社区重点与特殊人群的保健和管理	0.22
		B4协助处理突发公共卫生事件	0.11
		B5优生优育指导	0.04
		B6地方病的医疗服务	0.08
		B7掌握社区人口动态及人群健康状况和健康需求	0.06
		B8开展基本的精神卫生服务	0.04
		B9社区康复	0.08
C信息利用能力与管理能力	0.041 0	C1运用信息技术帮助诊治与患者健康教育	0.14
		C2合理控制患者医疗费用	0.19
		C3了解当地文化背景	0.11
		C4教学和指导能力	0.08
		C5合理地利用社区卫生资源	0.08
		C6医学信息检索、分析与应用	0.03
		C7组织指导社区护理工作	0.08
		C8建立与维护社区居民健康档案	0.24
		C9卫生政策和制度的相关知识	0.05
D医学知识与终身学习	0.244 8	D1医学基础知识	0.15
		D2临床医学知识	0.31
		D3流行病学和医学统计学知识	0.06
		D4循证医学知识	0.09
		D5社会科学知识	0.04
		D6学习意识和学习能力	0.19
		D7批判性思维能力	0.09
		D8创新素养与创新意识	0.06
		D9外语能力	0.02
E人际沟通与团队合作	0.138 9	E1良好医患关系的建立	0.08
		E2理解、信任并尊重患者及其家属	0.06
		E3保护患者隐私和知情权	0.12
		E4妥善应对伦理问题	0.05
		E5提高患者满意度	0.12
		E6积极预防和化解医患矛盾	0.18
		E7有技巧地向患者传达负面消息	0.05
		E8与患者和家属共同做出决策	0.06
		E9有效口头表达和传递信息能力	0.08
		E10与本团队同事良好协作的能力	0.08
		E11与其他团队建立良好的合作关系	0.12
F职业素养	0.244 8	F1恪守职业医疗法律法规	0.10
		F2基层服务意识	0.09
		F3自信心与客观的自我评价	0.05
		F4敬业精神	0.12
		F5具有爱心、同情心和同理心	0.11
		F6具备严谨、细致、敏锐的洞察力	0.10
		F7具备耐心和耐力，良好的心理调控能力	0.11
		F8行业自律和廉洁公正	0.10
		F9具有符合医生身份的仪表妆容	0.04
		F10利他主义和奉献精神	0.08
		F11成就导向	0.03
		F12有效安排自己的工作和职业生涯规划	0.07

Construction of Competency Model for Chinese Assistant General Practitioners Based on Delphi and Analytic Hierarchy Process

基于德尔菲法和层次分析法的中国助理全科医生岗位胜任力模型构建研究

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