Study On The O*NET Based Competencies Of Chinese Doctors

Background and PurposeCompetencies are the skills,knowledge,core values and professionalism that a qualified doctor should have in the clinical work.The competencies-based cultivation of medical students is the core content of the 3^rd generation medical reform.Identifying the competencies of clinical doctors is the prerequisite for improving medical quality.The purpose of the study is to identify the framework and behavioral standard of doctors'competencies by learning from the idea and experiences of advanced countries and considering the characteristics and realities of China.Thus provide references for the competencies-based global 3^rd medical education reform.MethodsWe conducted a survey from June to December in 2012.We investigate 1960 doctors by using O*NET-GWAs and WS questionnaires of the US Department of Labor.We analyze the questionnaires with SPSS 18.0 and AMOS 18.0 software and constructed the initial competency framework.We made 7 focus group interviews in the surveyed provinces,and analyzed the interview with Nvivo 8.0 software on the basis of Grounded Theory.We compared and combine ACGME,CanMEDS and GMER framework with ours and finally constructed the competencies model and behavioral standard of the Chinese clinical doctors.On the basis of the model,we give suggestions to the reform of medical education of China.Results1774 questionnaires?90.61%?were valid retrieved.The overall Conbach's?of the O*NET GWAs and WS questionnaires was 0.9 and the KMO was 0.97.In Bartlett's spherical analysis,?² was 38417.52?df=1596?,P<0.001,which showed good reliability and validity of the questionnaires.In exploratory factory analysis,the questionnaires showed a 6-factored solution.In confirmatory factory analysis,?²/df=3.89,GFI=0.92,AGFI=0.90,RMSEA=0.07,the model fitted well,and the 6elements and 38 items of the initial framework were verified.In the focus group interview,7 groups accomplished 592 minutes interviews and were translated to83744 word.By Nvivo 8.0 analysis,52 open codes,38 axial codes and 6 selected codes were identifies.We compared the framework with ACGME,CanMEDS and GMER framework and constructed the competencies model and behavioral standard the Chinese doctor.The model has 6 core competencies,52 basic requirements and200 behavioral standards.We also designed the graph of the model.By analysis of the situation of China,we suggested that competencies based reform in undergraduate education,medical resident training program and continuing medical education.Conclusions1.In this study we use the O*NET GWAs and WS questionnaires to analyze 1960doctors from 7 provinces of China.We build the framework of competencies of doctors?the first grade items?.This study was the first national-wide research of doctor-competencies in China.We found that Chinese and American doctors had common characters as well as different characters on O*NET.2.In this study we identified the competencies model and behavioral standard of Chinese doctors on the analysis of the O*NET questionnaires,focus group interview and Grounded Theory.The Chinese doctors'competencies framework includes six elements:?a?diagnosis and health management;?b?information and cost management?c?communication;?d?teamwork and construction;?e?professional behavior;and?f?professional value.The model identified 52 basic requirements and 200 behavioral standards for doctors.We designed the graph of the model.By comparisons between the model among ACGME,CanMEDS,and GMER framework,our competencies model and behavioral standards demonstrated comprehensive coverage and consistency to the actual situations of China.3.We suggested the appliance of the competencies model to the medical education reform of China.