In outpatient clinics, physicians serve as the primary providers of medical treatment activities; their positive attitudes and effective patient-physician communication methods are essential for guaranteeing high-quality healthcare services.
To compare the outpatient doctor's emotional state and completion of communication details between outpatient doctor's experiential communication and GLTC communication. To provide a reference for improving a doctor's communication skills and emotional state in the future.
From July 2021 to January 2022, 24 outpatient doctors from 6 departments in 4 tertiary general hospitals in Nanjing, Jiangsu Province were randomly selected as the research objects. Outpatient doctor-patient communication scenes meeting the criteria were selected as observation scenes. All of the included outpatient doctors in the same cohort underwent an individual experiential communication program first (recorded as the experiential group). Next, they received training on the outpatient GLTC doctor-patient communication program. Finally, the doctors conducted outpatient GLTC communication one week later (recorded as the GLTC group). The experiential group and the GLTC group were compared in terms of the Brief Profile of Mood States (BPOMS) score before and after communication as well as the completion rate of communication details.
The fatigue dimension score of BPOMS after communication was higher than that before communication in the experiential group (P<0.05) ; After communication, The fatigue and confusion dimension score of BPOMS in the GLTC group were lower than the experiential group (P<0.05) ; the completion rate of communication details in the GLTC group such as kind gaze (reception), polite language (reception), smile (reception), not easily interrupting patients, timely nodding response, appeasement, informing the necessity, patience (experimental examination), consulting patients' opinions, patience (diagnosis and communication), popular explanation, language comfort, friendly attitude, getting up (ending and explaining), kind gaze (ending and explaining), polite language (ending and explanation), smile (ending and explanation) was higher than the experiential group (P<0.05) .
Compared with experiential communication, GLTC communication is more capable of improving doctors' emotional state and relieving doctors' fatigue. At the same time, the completion rate of the corresponding communication details is improved, but there is still room for improvement in the completion rate of some communication details.
Competency development is the core of residency training in general practice, as well as the key to training qualified general practitioners. Summative assessment can evaluate overall training outcome and the attainment of general practitioner competencies. Summative assessment in general practice is still in developing in China, and its relevance to competencies is relatively weak.
To develop competency based summative assessment indicator framework of residency training in general practice, and to provide reference for improving the summative assessment system in China.
From 2023-04-25 to 30, 32 experts from 10 provinces, including Beijing, Shanghai, Hebei, Jiangsu, Zhejiang, Liaoning, Inner Mongolia Autonomous Region, Hainan, Ningxia Hui Autonomous Region and Sichuan Province were invited to participate in Delphi Expert Survey. The indicator framework of summative assessment was established through literature review and Delphi expert survey. The weight of indicators was determined by multiplicative model.
In both the first and second rounds of expert survey, 32 questionnaires were issued and 32 were recovered, which were all valid. The positive coefficient was 100.0%, the authority coefficient was > 0.8, the importance coordination coefficient of indicators at all levels respectively was 0.382, 0.284, 0.265, and the feasibility coordination coefficient was 0.415, 0.359, 0.332. The final summative assessment indicator framework consisted of 6 first-tier indicators, 24 second-tier indicators and 50 third-tier indicators. The first-tier indicators include application of clinical professional knowledge and skills, the ability to take care of the family, the ability to provide basic public health services, the ability to communicate, cooperate and coordinate, humanistic ability and professionalism, clinical teaching and scientific research ability, and the weights were 0.505, 0.061, 0.109, 0.134, 0.125 and 0.066, respectively.
This study preliminarily explored and constructed competency based summative assessment indicator framework of residency training in general practice, which provides reference for further research on the contents of summative assessment and on the improvement of summative assessment system in China. The framework is important for improving the quality of residency training and competencies of general practitioners.
In standardized residency training for general practice trainees, the rotation time in various clinical specialties is short, and there is a wide range of learning content, requiring enhanced learning autonomy. General practice faculty would be dealing with trainees from a variety of backgrounds, including 5+3, transfer, professional masters, or 3+2 assistant general practitioners, interns, public health trainees. It was necessary to study how to enable different training targets to get what they need and achieve the desired training effect in training needed to be carefully studied.
The objective of this study was to explore a training method that addresses structural problems, enhances trainees' learning initiative, and cultivates their ability for deeper thinking.
At the end of each learning activity, immediate discussions were organized to address the following questions: "1. What have you learned through the study? 2. What other questions do you have? 3. What are the same or similar experiences that you can share with others? 4. What inspirations do you have for future work?" The paper conducted theoretical analyses of the four questions to elucidate the method's internal logic and trainees' thinking process. Corresponding questionnaires were designed for validation studies conducted in the General Practice Backbone Teachers' Training Class and the Grassroots Talent Class.
The training method received strong agreement from the trainees, with the composite score ranging between "strongly agreed" and "agreed". After conducting parameter tests, no statistical differences were found in the answers concerning gender, age, title, position, and working experience. However, statistical differences were observed in academic qualifications, work units, and participated training programs (P<0.05) .
The use of structural problems with progressive meanings and a flexible training format proved effective in stimulating deeper thinking among trainees. The higher level of acceptance observed in the Grassroots Talent Class suggested that the method was particularly applicable to primary general practitioners and can enhance their ability for deeper thinking.
Social environment and psychological factors have a notable impact on professional identity. Currently, there are no available studies on relationships between perception of workplace violence (WPV) by patients, psychological capital (PsyCap) , and professional identity among general practitioners (GPs) in China.
To investigate the relationships between perceived WPV by patients, PsyCap, and professional identity among GPs in China.
A self-administered electronic questionnaire survey was conducted with 4 632 GPs selected by use of stratified multistage random sampling from eastern, central, and western China between March and May 2021. The survey was used for collecting data mainly consisting of GPs' basic demographics, perceived WPV by patients, PsyCap, and professional identity. Spearman's correlation was used to analyze relationships between perceived WPV by patients, PsyCap, and professional identity. Hierarchical multiple regression analysis was used to analyze the effects of perceived WPV by patients and PsyCap on professional identity.
Altogether, 94.47% of the GPs (4 376/4 632) who handed in responsive questionnaires were included for analysis. Six hundred and twenty-four (14.26%) GPs had experienced WPV by patients in the past year. The average total scores of PsyCap and professional identity were (102.89±16.94) and (33.93±8.95) , respectively. The increase in the score of perceived WPV by patients was correlated with a decrease in the scores of PsyCap and its dimensions, and in the score of professional identity (P<0.01) . The increase in the scores of PsyCap and its dimensions was correlated with increased score of professional identity (P<0.01) . Hierarchical multiple regression analysis showed that the frequency of WPV by patients had a negative predictive effect on professional identity (low frequency, b=-0.071; intermediate frequency, b=-0.054; high frequency, b=-0.042; P<0.001) . PsyCap had a positively predicted effect on professional identity (b=0.330, P<0.001) , and it played a partial mediating role between perceived WPV by patients and professional identity.
The GPs' perceived WPV by patients, PsyCap, and professional identity are interrelated, and PsyCap plays a partial mediating role between perceived WPV by patients and professional identity. Great importance should be attached to the professional work environment, occupational status, and mental health among Chinese GPs.
As healthcare gatekeepers, the competency of community general practitioners (GPs) will directly determine the quality of their services. However, the requirements for the competency of community GPs are still unclear and relevant applied research is scarce.
To construct a competency assessment system for community GPs.
An item pool of the first draft of the Onion Model-based Competency Assessment System for Community General Practitioners (OMCASCGP) was created by use of literature review in January 2021, then items in which were screened and improved in accordance with the results of two rounds of email-based expert consultation conducted with a purposive sample of 52 experts in general medicine and general medical management from February to March 2021. The weight of each index was determined by using the Analytic Hierarchy Process.
The response rate, authority coefficient, judgment coefficient and the degree of familiarity with the index for both rounds of consultation were 100.0% (52/52) , 0.91, 0.904, and 0.916, respectively. The formal system is composed of 6 first-level indices, 15 second-level indices and 48 third-level indices. The 6 first-level indices with corresponding weights are basic information (0.085 7) , clinical capability (0.436 1) , public health capability (0.244 5) , humanistic literacy (0.110 4) , career development (0.082 7) , and other aspects (0.040 6) . The Kendall's W measuring inter-expert agreement on the first-, second- and third-level indices was 0.254, 0.302, and 0.341, respectively (P<0.001) .
The OMCASCGP developed by us has been validated to be scientific and reliable, which could be appropriately promoted as a tool for assessing the comprehensive competencies of GPs.
