Research On The Construction And The Current Situation Of Competency Model Of Medical Undergraduates In China

Objectives: In order to adapt to the new changes in the health needs of the modern society,in 2010,the International Commission on Education for Global Education in the 21 st Century published the 21 st Century Medical Education Outlook Report in The Lancet.The report pointed out that the world is experiencing the third On behalf of the reform of medical education,the concept of "taking health system as the center,system as the basis and ability as the guidance" is put forward.In order to adapt to the change of social demand for health,the medical curriculum model is gradually evolving from a model based on knowledge structure and process to a competency-based and competency-based one in the world.In November 2014,the Ministry of Education and other six departments promulgated the Opinions on Deepening the Collaboration of Medical Education and Deepening the Reform of Clinical Medical Talents Cultivation,and further explicitly proposed to deepen the education and teaching reform oriented by the post competency.As the subject and basis of medical education in our country,the undergraduate clinical medical specialty plays an important role in ensuring the successful reform of "5 + 3" integrated clinical personnel training mode.How to build a postgraduate competency model for undergraduate medical students according to the domestic and international undergraduate medical education standards and competency framework standards,make it clear that the post competency model adapting to national conditions is integrated into the undergraduate medical personnel training objectives,Basic medical personnel training mode,to enhance the quality of medical education has important and far-reaching significance.Materials and methods: On the basis of comprehensive literature analysis of domestic and foreign undergraduate medical education standards and doctors’ post competency model framework standards,24 undergraduate clinical medical graduates were interviewed for behavioral events,12 excellent groups,12 ordinary groups,combined with students.Interview results,after expert discussion,the preliminary preparation of the "Chinese Clinical Medicine Undergraduate Competency Survey Questionnaire"(teacher version),selected 450 professional teachers from 18 medical colleges in different regions of China as research subjects,undergraduate graduates Competency standards are evaluated for importance and feasibility,and a framework for competency model of Chinese clinical medical graduates is constructed.In the different regions of the country,1620 undergraduate graduates from six medical colleges were selected to evaluate the importance of graduate competency model standards,the status of competency and the status quo of undergraduate teaching.The competency model was further verified and revised by descriptive statistical analysis,t-test,analysis of variance,exploratory factor analysis,and confirmatory factor analysis.In the province of Liaoning,hospitalization doctors(890),clinical teachers(150),nurses(140),and management personnel(50)were invited to evaluate the current status of undergraduate graduates’ competence,combined with graduates’ competence.The results of the evaluation,analysis and comparison,to further understand the lack of graduates’ competence.Finally,through investigation,we can understand the shortcomings in the current undergraduate clinical medicine teaching in China.Result: 450 professional teachers participated in the evaluation of the competence of undergraduate students in clinical medicine in China.450 questionnaires were distributed and 372 were recovered,with a recovery rate of 93.3%.The overall reliability of the scale is 0.921,and the reliability of each dimension is greater than 0.7.The KMO value was 0.87 by factor analysis and the χ~2 value of the Bartlett spherical test was 9686.93.Principal component analysis was used to extract factors with eigenvalues greater than 1 and factor loading greater than 0.5 by orthogonal rotation.There are 6 factors that can extract feature values greater than 1,and the cumulative variance contribution rate is 68.14%.Delete 8 entries with a factor load less than 0.35.After discussion,the expert group decided to delete another entry.The final model contains 6 dimensions and 51 entries.The six dimensions are named “Medical and Related Knowledge”,“Clinical Skills and Disease Prevention”,“Academic Research and Lifelong Learning Ability”,“Information Technology and Management Competence”,“Interpersonal Communication Competence”,“Professional Quality,Ethics and teamwork".Of the 24 interview samples,2 were excluded from the interview.There was no significant difference in the length of interviews and interview time between the excellent group and the general group graduates.The consistency of the coding group code is acceptable.The results of the interviews between the two coding groups yielded 7 benchmark competencies and 5 identified competency.Throughout the country,1620 graduates from different regions were invited to use the “Chinese Clinical Medicine Undergraduate Competency Model Survey Form”(Student Edition)to evaluate the importance and status of the competency,and recover 1585 copies.The analysis yielded a KMO value of 0.91 and the Bartlett spherical test had a χ~2 value of 12321.77.Principal component analysis method is used to extract 6 factors with eigenvalue greater than 1 after orthogonal rotation.The cumulative contribution rate of 6 factors is 69.33%.The results of confirmatory factor analysis showed that χ~2=4238.364,p=0.12,the result was not significant,χ~2/df= 3.571,CFI was 0.902,AGFI was 0.812,RMSEA was 0.07,which indicated that the model fits well.Accepted model.The overall level of competency of undergraduate graduates is not high in all dimensions,especially the lack of training in the two areas of “interpersonal communication skills”,“professional quality,ethics and teamwork”,and some capacity training is lacking.Conclusions: 1.Compared with domestic and foreign medical education standards and physician position competency models,the post-employment model of Chinese clinical medical undergraduate graduates is in line with China’s undergraduate medical education standards.The competency model is basically consistent in content and field,and still needs further basis.Domestic education is actually supplemented or revised.2.The construction process of the competency model of Chinese undergraduate clinical medicine graduates is scientific,reliable and basically in line with China’s national conditions.3.The status quo of China’s clinical medical undergraduate graduates’ competence is not optimistic,and the overall level is insufficient.In particular,it is necessary to strengthen the training of weak links such as interpersonal communication,professionalism and quality training among medical students.4.There are many shortcomings in the training objectives,educational methods,educational resources and evaluation methods of undergraduate teaching in clinical medicine in China.It is necessary to further adapt to the new social health requirements,and actively carry out the reform of medical talent training mode based on post competence,and optimize provide reference for 5+3" integrated clinical medical professionals.