全科医师核心能力评价指标体系构建研究

Construction of Core Competency Evaluation Index System for General Practitioner

目的构建全科医师核心能力评价指标体系,用于指导全科医师的能力培养与评价。方法通过文献分析法和小组访谈法初步拟定全科医师核心能力评价指标体系框架,采用Delphi法对15名专家进行两轮问卷咨询,使用层次分析法进行指标权重确定。结果两轮咨询的有效回收率分别为86.7%、100.0%,专家的权威系数、熟悉程度、判断系数均>0.70。一级指标的协调系数为0.486,二级指标的协调系数为0.655,P值均<0.05。全科医师核心能力评价指标共42项,其中一级指标6项,二级指标36项,解决具体临床问题的技能、以病人为中心的照顾能力、基层保健管理能力、基于医疗服务系统的执业能力、专业能力、基于实践的学习与改进能力六项一级指标的权重分别为0.162 5、0.186 7、0.275 0、0.115 8、0.146 5和0.113 5。结论本研究建立的全科医师核心能力评价指标体系具有较好的系统性与科学性。

Objective To construct a core competency evaluation index system for general practitioner （GP） to guide the training and competency evaluation of GP. Methods Litei＇ature review and focus group discussion were used to formulate the primary framework of the core competency evaluation index system. Fifteen experts were consulted applying two - round Delphi method. The weight of each indicator was determined through hierarchy analysis. Results The valid response rates of two rounds were 86. 7% and 100. 0%, respectively. The authority coefficient of the experts, familiarity degree and coefficient of determina- tion were 〉 0. 70, respectively. The concordance coefficients of the first - class indicators and the second - class indicators were 0. 486 and 0. 655, respectively （ P 〈 0. 05 ） . The index system consisted of 6 first - class indicators and 36 second - class indica- tors. The weights of the 6 first - class indicators were 0. 162 5 for ability to solve specific clinical problems, 0. 186 7 for patient - centered care, 0. 275 0 for primary care management, 0. 115 8 for ability of system - based practice, O. 146 5 for professional capability, and 0. 113 5 for ability to learn and develop their skills based on the practice. Conclusion The core competency e- valuation index system developed in this study could evaluate the GP＇s competency systematically and scientifically.