Library of China Medical University, Shenyang, China.
Department of Science and Education, Chaoyang Central Hospital, Chaoyang, China.
Hum Resour Health. 2024 May 27;22(1):31. doi: 10.1186/s12960-024-00912-1.
The Chinese government has formulated a series of policies and strengthened training of general practitioners (GPs) to support their role as "gatekeepers" of residents' health. This study aimed to explore the core competencies of Chinese GPs and develop a competency framework in line with China's actual conditions, which can provide a more scientific basis for the education, training, and evaluation of GPs.
Literature analysis and behaviour event interviews were conducted to build the competency dictionary and the initial version of the competency model. Two rounds of Delphi were performed to gain consensus on the final model. The questionnaire survey was carried out in 10 provinces (municipalities, autonomous regions) of China, and GPs were invited to score the importance of each competency item. The total sample was randomly divided into two groups. One group was for exploratory factor analysis (EFA), and the other was for confirmatory factor analysis (CFA) to examine the scale's reliability and validity.
The dictionary of general practitioners' competency including 107 competency items was constructed. After two rounds of Delphi, a consensus was reached on 60 competencies in 6 domains. A total of 1917 valid questionnaires were obtained in the nationwide survey. The average importance score of all second-level indicators is 4.53 ± 0.45. The Cronbach's α coefficient is 0.984. The results of the five factors extracted by EFA showing the 68.16% cumulative explained variance variation is considered to be consistent with the six dimensions obtained by Delphi after thorough discussion. The model fitness indexes obtained by CFA were acceptable (χ/df = 4.909, CFI = 0.869, NFI = 0.841, RMSEA = 0.065). The values of the composite reliability (CR) of the six dimensions were all greater than 0.7 (0.943, 0.927, 0.937, 0.927, 0.943, 0.950), and the average of variance extracted (AVE) were all greater than 0.5 (0.562, 0.613, 0.649, 0.563, 0.626, 0.635). The results showed that the model has good reliability and validity.
A competency model for GPs suited to China has been developed, which may offer guidance for future training and medical licensing examinations of GPs.
中国政府制定了一系列政策并加强了对全科医生的培训，以支持他们作为居民健康“守门人”的角色。本研究旨在探讨中国全科医生的核心能力，并制定符合中国实际情况的能力框架，为全科医生的教育、培训和评估提供更科学的依据。
采用文献分析和行为事件访谈法构建能力词典和能力模型初稿。进行两轮德尔菲法以达成对最终模型的共识。在中国 10 个省（直辖市、自治区）进行问卷调查，邀请全科医生对每个能力项目的重要性进行评分。总样本随机分为两组，一组进行探索性因子分析（EFA），另一组进行验证性因子分析（CFA），以检验量表的信度和效度。
构建了包括 107 项能力条目在内的全科医生能力词典。经过两轮德尔菲法，就 6 个领域的 60 项能力达成共识。全国调查共获得 1917 份有效问卷。所有二级指标的平均重要性评分为 4.53±0.45。克朗巴赫α系数为 0.984。EFA 提取的五个因子的结果显示，68.16%的累积解释方差变化被认为与德尔菲法讨论后得出的六个维度一致。CFA 模型拟合指数可接受（χ/df=4.909，CFI=0.869，NFI=0.841，RMSEA=0.065）。六个维度的组合可靠性（CR）值均大于 0.7（0.943、0.927、0.937、0.927、0.943、0.950），平均方差提取量（AVE）均大于 0.5（0.562、0.613、0.649、0.563、0.626、0.635）。结果表明，该模型具有良好的信度和效度。
制定了适合中国国情的全科医生能力模型，可为未来全科医生的培训和医学执照考试提供指导。
