The Study On Competency Model Of Research Oriented Physician

ObjectivesThe construction and development of research oriented hospital put forward higher research capacity for the clinicians,which bring the concept of research oriented physician(ROP)into our vision.The purpose of this study is to build the differentiating competency model(DCM)and threshold competency model(TCM)of research oriented physician,through systematically combining the competency theory and the research oriented physician theory.MethodsThe main methods used in this study include literature analysis,empirical investigation,expert panel and statistical analysis.The literature analysis refers to systematically reviewing theories of competency and ROP by analyzing relevant literature at home and abroad,which lays the theoretical foundation for this research.The empirical investigation includes field investigation,behavior event interview(BEI)and questionnaire investigation.By on-the-spot investigating the hospital that cultivating ROP,the theoretical basis of ROP is then further enriched.By conducting the BEI for the 11 excellent ROP and10 qualified ROP,the DCM and TCM are initially constructed.The competency rating scale is then designed based on the two competency models,by which the survey of 425subjects that related to the ROP is conducted in order to test the identity and reliability of the DCM and TCM.Expert panel means the relevant experts are consulted to ensure the scientificity of the results during the whole stage of this study,including hospital administrator,hospital management researchers,senior physicians,etc.Statistical analyses include basic statistical analysis such as descriptive statistical analysis,t-test and advanced statistical analysis such as exploratory factor analysis(EFA),confirmatory factor analysis(CFA),which ensures the objectivity of the construction and testing of the competency models.ResultsThe research results are mainly divided into two parts:competency model construction and testing.1.Competency model construction(1)Descriptive statisticsThe 21 subjects included in the study met the criteria of ROP,and there was a clear performance difference between the excellent and qualified groups.No significant difference is observed between the two groups in the aspect of interview time and the interview words,which means the two groups are comparable.(2)Competency encodingThe frequency,average grade score and highest grade score of competency that significantly related to the interview words are 4 items,3 items and 4 items,respectively.It means that the use of average grade score as the basis for modeling in this study is reasonable.The average coefficient of category agreement is 0.617,and the average coefficient of reliability was 0.763.A total of 26 competencies were significantly correlated between the two encoders in the aspect of frequency,average grade score and highest grade score,respectively.(3)Competency difference comparisonBy comparing the differences of the competency average grade score between the excellent and qualified groups,the DCM and TCM are initially constructed.DCM comprises 14 competencies such as achievement orientation,responsibility,etc.TCM comprises 18 competencies such as honesty and integrity,self-confidence,etc.2.Competency model testing(1)Descriptive statisticsThe subjects are closely related to the ROP,most of whom were clinicians at the large Tertiary Grade A hospitals.Their recognition for the competency contained in the competency model is relatively high,and the average score is above 4 for all the competency.(2)Validity analysisThe content validity and criterion-related validity are ensured through scientific rigorous design and expert suggestion.To check the construct validity,by numbering the sample data from 1 to 425,we first conduct EFA for the odd group that contains 213subjects and then conduct CFA for the even group that contains 212 subjects.(1)Factor analysisThe KMO for DCM and TCM are 0.873 and 0.881,respectively.Both of the two models'Bartlett's sphericity test are significant and the communality are relatively high.These results show that the DCM and TCM are both suitable for factor analysis.According to the results of cumulative coefficient of variation and scree plot,three common factors are included in the two competency models,and the cumulative variation rates are 64.017%and 60.082%,respectively.After conducting factor loading matrix with orthogonal rotation,the internal structure of the two competency models are clear.In the DCM,the common factor F1 has six competency,including problem finding,systematic thinking,organizational awareness,devotion to organization,innovation capability and specialized characteristic;the common factor F2 has five competency,including empowerment,leadership ability,regulation building and optimization,talent cultivating,sociability;the common factor F3 has three competency,including achievement orientation,responsibility,initiative and plan.In the TCM,the common factor F1 has ten competency,including insistence and perseverance,self-awareness and evaluation,honesty and integrity,learning ability,strategic positioning,self-confidence,logic analysis,expertise foundation,the concern for working conditions,medical service;the common factor F2 has four competency,including research output,academic communication,research initiation and practice,literature review and analysis;the common factor F3 has four competency,including teamwork,communication and coordination,flexibility,patient service awareness.(2)Structural equation modelThe model fitting results show that the load distribution of DCM and TCM are both uniform.The fitting effect is relatively ideal,and the DCM's fitting effect is better than that of the TCM.The model evaluation results show that the performance of absolute fit index,comparative fit index and information criteria fit index in both of the two competency models are relatively ideal,and DCM's evaluation result is better than that of TCM.The?~2/df of DCM and TCM are 2.708 and 3.563,the GFI are 0.883 and 0.793,and the NFI are0.817 and 0.724,respectively.(3)Reliability analysisThe split-half reliability of DCM and TCM are 0.858 and 0.826,respectively.For the DCM,the Cronbach's alpha coefficient of the overall competency model and the common factor F1,F2 and F3 are 0.888,0.837,0.840 and 0.656,respectively.For the TCM,the Cronbach's alpha coefficient of the overall competency model and the common factor F1,F2 and F3 are 0.915,0.883,0.814 and 0.757,respectively.3.Factor namingWith reference to the competency in each factor,the three common factor F1,F2 and F3 of DCM are named innovation ability and organizational consciousness,management ability,achievement consciousness,respectively;the three common factor F1,F2 and F3 of TCM are named cognitive ability,scientific practical ability,collaboration ability and service consciousness.ConclusionIn the aspect of competency model building,we highly suggest that the scientific,standard and objective methods should be adopted when constructing competency model.We also hope that with the promotion of ROP cultivating system,future research could further deeply analyze the competence of ROP,so as to improve the identification of ROP's competency model.In the aspect of competency model application,we suggest that the evaluation and training system of ROP,based on competency models,should be established.The physician themselves can also make the ROP competency models as a reference to enhance their own competencies comprehensively.