Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Yonago, 683-8503, Japan.
BMC Prim Care. 2023 Jan 19;24(1):21. doi: 10.1186/s12875-023-01984-z.
In recent years, the growing global urbanization and urban population have resulted in the emergence of various health problems unique to urban areas. Therefore, training general practitioners and family physicians who can tackle the complex health problems of urban areas and improve the health of urban people is one of the most important issues of our time. However, findings on competencies for urban general practitioners (GP) and family physicians (FP) were limited. This study aimed to identify their comprehensive and content-validated list of competencies.
We used the modified Delphi method to develop a content-validated competency list. First, we analyzed and synthesized the competencies extracted from the literature review using qualitative thematic analysis methods to create an initial competency list of 34 items. We then assembled 39 expert panelists in four groups of study participants: physicians, nurses, patients, and medical education specialists. The expert panelists were asked to indicate their level of agreement with the lists and provide revised comments on the description of each competency via a web-based questionnaire. Their responses were analyzed quantitatively and qualitatively by the research team and used to revise the list. These processes were repeated, and the survey was completed when it was determined that consensus had been reached.
Three rounds of Delphi were conducted. 39 responded in the first round, 38 in the second round, and 36 in the third round. The initial list of competencies was revised and consolidated from 34 to 14 items in the first round, bringing the total to 20 items along with six new items proposed by the panelists. In the second round, it was revised and consolidated into a list of 18 items. In the third round, all 18 items were considered to have been agreed upon by the panelists, so the survey was closed.
We identified a comprehensive 18-item list of competencies for urban GP/FP in a content-validated manner. Several are newly discovered competencies in this study. The findings of this study will be useful for the future training of urban GP/FP and for solving urban health problems.
近年来，全球城市化和城市人口的增长导致了各种独特的城市地区健康问题的出现。因此，培养能够解决城市地区复杂健康问题并提高城市居民健康水平的全科医生和家庭医生是我们这个时代最重要的问题之一。然而，关于城市全科医生（GP）和家庭医生（FP）的能力的研究结果有限。本研究旨在确定他们全面且内容有效的能力清单。
我们使用改良 Delphi 法制定了一份内容有效的能力清单。首先，我们使用定性主题分析方法分析和综合从文献综述中提取的能力，创建了一个包含 34 项初始能力的清单。然后，我们将 39 名专家组成员分为四个研究参与者小组：医生、护士、患者和医学教育专家。要求专家组成员就清单的内容表示同意，并通过网络问卷就每项能力的描述提供修订意见。研究团队对他们的回复进行了定量和定性分析，并根据分析结果对清单进行了修订。这些过程重复进行，直到达成共识为止。
进行了三轮 Delphi 调查。第一轮有 39 人回复，第二轮有 38 人回复，第三轮有 36 人回复。在第一轮中，从 34 项修订和整合为 14 项，总计 20 项，其中 6 项是专家组成员提出的新内容。在第二轮中，进一步修订和整合为 18 项。在第三轮中，专家组一致认为所有 18 项都已达成共识，因此调查结束。
我们以内容有效的方式确定了全面的 18 项城市全科医生/家庭医生能力清单。其中一些是本研究中发现的新能力。本研究的结果将有助于未来城市全科医生/家庭医生的培训和解决城市健康问题。
