中国乡村全科执业助理医师岗位胜任力指标体系的构建

Construction of index system for post competency of rural general practice assistant physicians

目的构建乡村全科执业助理医师岗位胜任力指标体系。方法该研究为质性研究。在前期文献研究和行为事件访谈的基础上编制德尔菲专家咨询问卷,于2019年10月至2020年1月对相关专家进行函询,根据咨询结果构建乡村全科执业助理医师岗位胜任力指标体系,并运用层次分析法确定各指标权重。结果共纳入咨询专家26名,年龄(48.7±8.6)岁,工作年限(22.8±8.8)年。经过2轮咨询形成了乡村全科执业助理医师岗位胜任力指标体系,包括一级指标6个,二级指标60个,2轮专家的积极系数分别为87%和100%,权威系数介于0.7~1.0,协调系数分别为0.312和0.241(P<0.001)。一级指标按权重大小依次为“基本医疗卫生服务”(0.3111)、“基本公共卫生服务”(0.1960)、“医学知识与终身学习”(0.1960)、“人际沟通与团队合作”(0.1386)、“职业素养”(0.1028)、“信息利用能力与管理能力”(0.0555)。二级指标中,组合权重排在前3位的依次为“临床专业知识”(0.0792)、“学习意识和学习能力”(0.0553)、“合理用药”(0.0431),后3位分别为“成就导向”(0.0016)、“归纳思维”(0.0020)、“灵活性”(0.0023)。结论该研究初步构建了乡村全科执业助理医师岗位胜任力指标体系,可为相关人才的选拔、培养及考核提供参考。

Objective To construct a post competency index system for rural general practice assistant physicians.Methods On the basis of previous literature research and behavioral event interviews,the questionnaire of Delphi consultation was designed.Two rounds of Delphi expert consultation were conducted from October 2019 to January 2020 to develop an index system of post competency for rural general practice assistant physicians,and the analytic hierarchy process methods was used to calculate the weight of each index.Results A total of 26 experts were included,with an average age of(48.7±8.6)years and an average working seniority of(22.8±8.8)years.After 2 rounds of consultation,the competency index system was developed,including 6 first level items and 60 seconds level items.The positive coefficient of experts in the 2 rounds was 87%and 100%,respectively;the expert authority coefficient was 0.7-1.0;the coordination coefficient was 0.312 and 0.241,respectively(P<0.001).According to the order of weight,the first level items were basic medical and health services(0.3111),basic public health services(0.1960),medical knowledge and lifelong learning(0.1960),interpersonal communication and team cooperation(0.1386),professional quality(0.1028),information utilization and management ability(0.0555).The top 2 secondary indexes were clinical expertise(0.0792),learning awareness and ability(0.0553).The last 2 secondary indexes were achievement orientation(0.0016)and inductive thinking(0.0020).Conclusion A post competency index system for rural general practice assistant physicians has been preliminary constructed in this study,which may provide reference for the selection,training and assessment of relevant medical workers.