全科医生岗位胜任力评价指标体系的构建研究

Construction of Evaluation Index System of Post Competency of General Practitioners

目的构建用于评判全科医生岗位胜任力的指标体系,为全科医学人才培养、考核评价提供参考依据。方法于2015年9—11月,采用目的抽样法,分别从熟悉全科医学理论前沿、从事全科医疗实践和行政管理3类人员中遴选咨询专家38例。运用文献研究法和德尔菲法确定全科医生岗位胜任力评价指标体系;运用层次分析法计算各指标权重。结果建立了4个一级指标、11个二级指标、57个三级指标的全科医生岗位胜任力评价指标体系。一级指标基本医疗服务能力、公共卫生服务能力、人文执业能力、教育学习能力的权重分别为0.482 9、0.295 7、0.129 7、0.091 7。二级指标中,组合权重排在前3位的为临床诊疗技能(0.193 2)、综合医疗服务能力(0.193 2)、预防服务能力(0.181 7),排在后3位的为教学科研能力(0.018 3)、医学人文关怀(0.032 4)、医学职业素养(0.032 4)。三级指标中,组合权重排在前3位的为首诊与转诊服务(0.066 6)、常见病/多发病的诊断与处理(0.051 4)、家庭医疗及健康评估服务(0.040 6)、康复医疗服务(0.040 6),排在后3位的为医学经济决策能力(0.001 6)、批判性思维能力(0.002 0)、医学法学能力(0.003 0)、教学与培训评估/评价(0.003 0)、科研/调研能力(0.003 0)。结论本研究构建了全科医生岗位胜任力评价指标体系,为全科医生的培养、考核、评价提供了客观的依据,但需进一步实证研究验证、细化以及修正各指标。

Objective To construct the evaluation index system of post competency of general practitioners and to provide references for talents training,appraisal and evaluating of general medicine.Methods From September to November of2015,by purposive sampling method,38 consultant experts were selected respectively from the following 3 types of personnel：who were familiar with the frontier theory of general medicine,engaged in general medical practice and administrative management.The literature review method and Delphi method were used to determine evaluation index system of post competency of general practitioners; and the analytic hierarchy process was used to calculate the weight of each index.Results The evaluation index system of post competency of general practitioners with 4 first grade indexes,11 second grade indexes and 57 third grade indexes had been constructed.The weights of the first grade indexes including basic medical service ability,public health service ability,humanitic practicing ability,and education learning ability were 0.482 9,0.295 7,0.129 7,and0.091 7 respectively.The top 3 combined weights of the second grade indexes were clinical diagnosis and treatment skills（ 0.193 2）,public health service capacity（ 0.193 2）,prevention service capacity（ 0.181 7）,and the bottom 3 were the teaching scientific research ability（ 0.018 3）,medical humanistic care（ 0.032 4）,and medical professionalism（ 0.032 4）.The top 3 combined weights of the third grade indexes were initial diagnosis and referral service（ 0.066 6）,diagnosis and treatment of common / frequently-occurring disease（ 0.051 4）,family medical and health assessment services（ 0.040 6） and rehabilitation medical services（ 0.040 6）,and the bottom 3 were medical economic decision-making ability（ 0.001 6）,critical thinking ability（ 0.002 0）,medical law ability（ 0.003 0）,teaching and training evaluation / assessment（ 0.003 0）and scientific research / investigation ability（ 0.003 0）.Conclusion The study has constructed the evaluation index system of post competency of general practitioners and provided objective basis for the training,appraisal and evaluation of general practitioners.However,further empirical researches are needed to verify,refine and amend each indicator in the system.