The clinical thinking of general medicine is based on the characteristics of the general medicine profession and has its uniqueness, requiring general practitioners to have "patient-centered" clinical diagnosis and treatment skills. In order to better reflect the clinical thinking ability of clinical residents in general practice, it is necessary to establish a set of effective evaluation criteria that can reflect all aspects of their ability. At present, there is no suitable method to evaluate the clinical thinking ability of residents in general practice.

To construct a post competency oriented clinical thinking ability evaluation system for general practice residents by Delphi method.

From December 2021 to February 2022, based on literature research, we preliminarily constructed the evaluation system framework of clinical thinking ability of general residents. Delphi method was used to conduct two rounds of in-depth communication with 12 experts to give objective evaluation on the importance of the indicators in the framework. Futher, we use analytic hierarchy process to determine the weight of each indicator.

Through two rounds of expert consultations, we developed a comprehensive evaluation system consisting of 5 first-level indicators (clinical knowledge learning and extension, data collection and utilization, diagnostic analysis and utilization, treatment decision making ability, communication and collaboration ability) and 30 second-level indicators. The effective response rate of the two rounds of questionnaire was 100.0%, the expert authority coefficient was 0.85, and the expert coordination coefficient of the first and second indexes were 0.299 and 0.189 respectively (P<0.01). And the weight of 5 first-level indicators were 0.198, 0.198, 0.227, 0.227, 0.150 respectively.

Delphi method was used in this study to establish a comprehensive evaluation system of clinical thinking ability of residents. Through the analysis of the result data, it can be seen that the evaluation system is highly authoritative and scientific, which can provide reference for training high-quality general residents and improving the teaching quality of general practice in the future.

全科医学的临床思维基于全科医学专业的自身特点，有其独特性，要求全科医师具备"以患者为中心"的临床诊断和治疗技能。为了更好地反映出全科临床住院医师的临床思维能力，需要建立一套完善的、可以反映出其全方面能力的有效评价标准，目前尚无适用于衡量全科住院医师临床思维能力的评价体系。

通过德尔菲法（Delphi法）构建全科住院医师以岗位胜任力为导向的临床思维能力评价体系。

2021年12月—2022年2月，本课题组基于文献研究初步构建了全科住院医师临床思维能力指标体系框架，运用Delphi法，与12位专家进行了两轮深入沟通，就指标的重要性给出客观评估，筛选出合适的指标，并运用层次分析法确定每个指标的权重。

通过两轮专家咨询，本课题组建立了一个综合性的评估体系，其中包括5个一级指标（临床知识学习和扩展、资料收集和利用、诊断分析和利用、治疗决策能力、沟通和合作能力）以及30个二级指标。两轮咨询问卷有效回收率达到100.0%，专家权威系数为0.85，一级和二级指标的专家协调系数分别达到了0.299和0.189（P<0.01），一级指标的权重分别为0.198、0.198、0.227、0.227、0.150。

本研究使用Delphi法建立一个全面评价住院医师临床思维能力的评估体系。经过对结果数据分析可知该评估体系具有较高的权威性和科学性，为今后培养高质量全科住院医师，提升全科医学教学质量提供了参考。