Department of Psychology, University of Cambridge, Cambridge.
Br J Gen Pract. 2013 May;63(610):e331-8. doi: 10.3399/bjgp13X667196.
Recent structural and policy changes in the UK health service have significantly changed the job responsibilities for the GP role.
To replicate a previous job analysis study to examine the relevance of current competency domains and selection criteria for doctors entering training.
A multisource, multimethod approach comprising three phases: (1) stakeholder consultation (n = 205) using interviews, focus groups and behavioural observation of practising GPs; (2) a validation questionnaire based on results from phase 1 (n = 1082); followed by (3) an expert panel (n = 6) to review and confirm the final competency domains.
Eleven competency domains were identified, which extends previous research findings. A new domain was identified called Leading for Continuing Improvement. Results show that, Empathy and Perspective Taking, Communication Skills, Clinical Knowledge and Expertise, and Professional Integrity are currently rated the most important domains. Results indicate a significant increase in ratings of importance for each domain in the future (P<0.001), except for Communication Skills and Empathy and Perspective Taking, which consistently remain high.
The breadth of competencies required for GPs has increased significantly. GPs are now required to resolve competing tensions to be effective in their role, such as maintaining a patient focus while overseeing commissioning, with a potential ethical conflict between these aspects. Selection criteria remain largely unchanged but with increased priority in some domains (for example, Effective Teamworking). However, there is an urgent need to review the training provision arrangements to reflect the greater breadth of competencies now required.
英国卫生服务领域最近的结构和政策变化，极大地改变了全科医生的工作职责。
复制之前的一项工作分析研究，以检验当前医生培训准入的能力领域和选拔标准的相关性。
采用多来源、多方法的方法，包括三个阶段：（1）利益相关者咨询（n=205），采用访谈、焦点小组和对执业全科医生的行为观察；（2）基于第 1 阶段结果的验证问卷（n=1082）；然后是（3）一个专家小组（n=6），对最终的能力领域进行审查和确认。
确定了 11 个能力领域，这扩展了之前的研究结果。一个新的领域被确定为领导持续改进。结果表明，同理心和换位思考、沟通技巧、临床知识和专业知识、以及专业诚信目前被认为是最重要的领域。结果表明，每个领域在未来的重要性评分都显著增加（P<0.001），除了沟通技巧和同理心和换位思考，这两个领域一直保持较高水平。
全科医生所需的能力范围显著扩大。全科医生现在需要解决竞争压力，在监管委托的同时保持对患者的关注，这可能会导致这些方面之间存在潜在的伦理冲突。选拔标准基本保持不变，但在某些领域（如有效团队合作）的优先级有所提高。然而，迫切需要审查培训安排，以反映当前所需的更广泛的能力。
