全科住院医师临床综合能力评价指标体系的研究

Establishment of assessment system for comprehensive clinical competency of general practice residents

目的建立全科住院医师临床综合能力评价指标体系，有效地衡量全科医师的临床能力。方法在2010年11月至2011年10月间，采用改进的Delphi专家咨询法，在上海市全科医师规范化培训临床基地和社区基地，遴选33名相关专业（全科医疗、教学、行政管理）的专家进行了两轮函询。结果两轮函询中专家的积极系数均为100％；权威程度分别为0．852和0．855；评价指标重要性的专家协调系数分别为0．228和0．245（P=0．000），专家意见渐趋一致。最终建立了一套由5个一级指标（职业态度、沟通技能、临床能力、社区实践能力、职业发展能力）和36个二级指标组成的指标体系，用于上海市全科住院医师临床综合能力的评价。结论建立的指标体系设置合理，能全面、客观地衡量全科住院医师的临床综合能力。

Objective To establish a assessment system for comprehensive clinical competency of general practice residents. Methods An assessment system for comprehensive clinical competency of general practice residents was developed with modified Delphi expert consultation during November 2010 to October 2011. Thirty three experts in clinical practice, education and administration of general practice were invited for two-round Delphi questionnaire consultation. Results In two-round consultation, the expert activity coefficient was 100%, the authority coefficient was 0. 852 and 0. 855, and the coordination coefficient for the importance of the indicators was 0. 228 and 0. 245 respectively （ P ： 0. 000）. The opinions among the experts became consistent from round 1 to round 2. An assessment system was established, which consisted of 5 first-level （professionalism, communicate skills, clinical competency and professional development ability ） and 36 second-level indicators. Conclusion The index system established in this study may be used as references for evaluating comprehensive clinical abilities of general practitioners systematically and objectively.