Research On The Construction Of Competency Model For Chinese Assistant General Practitioners

Objective: By constructing a scientific and reasonable assistant general practitioner competency model,this research aims to provide support for the improvement of the design of the national assistant physician qualification examination and the theoretical basis for the training and selection of assistant general practitioners.Methods:(1)Through the literature research method to collect and sort out the competency research related to this research topic,and initially establish the competency model.(2)By behavioral event interview method,in January 2019 to June,through snowball sampling method,23 general practitioners and assistant general practitioners were surveyed,including 14 general practitioners in the excellent group and 9 assistant general practitioners in the general group,Coding analysis was carried out on the interview content,and statistical methods of t test and rank sum test were adopted to screen competency factors.Finally,the competency model of assistant general practitioners was preliminarily constructed,and at the same time,the differentiating competency characteristics and benchmark competency characteristics of assistant general practitioners were extracted.(3)Based on the Delphi expert consultation method,from September 2019 to January 2020,30 general medicine experts from 18 provinces and municipalities in China were selected by the method of target sampling.On the basis of competency entry for Delphi expert questionnaire,expert evaluated the rationality of the entry and connotation and significance,using Epidata3.0 for data input.According to the correlation formula,positive coefficient,variation coefficient and the coordination coefficient were calculated by SPSS21.0.Finally,the index and connotation were revised and improved based on expert opinions,and the competency index system of assistant general practitioners was preliminarily constructed.(4)Analytic Hierarchy Process(AHP)was used to determine the weight of every index.The importance score of indicators in the second round of Delphi Expert Questionnaire was calculated to get the weight of every indicator by Excel.Results:(1)Through literature analysis and behavioral event interview,the entry pool of competence is preliminarily established,together with half-dozen first-level indicators and eighty one second-level indicators,and therefore the second level index was explained.At the same time,three differentiating competencies of assistant general practitioners were extracted,including "clinical thinking of general practitioners","understanding of medical system and related policies" and "critical thinking ability".10 benchmark competencies were "key appointments and history collection","effective follow-up of patients","have a solid basic knowledge of medical science","building and development partners of the doctor-patient relationship with patients","actively prevent and defuse doctor-patient contradiction","establish good relations of cooperation with other team","professional dedication","with love,compassion and empathy","patience and endurance,good psychological adjustment ability",and "rigorous,careful,keen insight".(2)Delphi expert consultation method was used to complete the preliminary construction of assistant general practitioner competency model.Including half dozen first-level indicators,sixty-three second-level indicators.The authority coefficient of experts was 0.95,the positive coefficient of experts in the 2 rounds was 0.83 and 0.92,and therefore the coordination coefficient in the two rounds was 0.368 and 0.345(P<0.01).(3)Weight coefficient of each index was determined,primary index according to the weight coefficient from high to low in turn as follows: the basic medical and health services(0.2448),medical knowledge and life-long learning(0.2448),and professional quality(0.2448),interpersonal communication and team work(0.1389),the basic public health services(0.0858),the information utilization ability and management capacity(0.0410).Conclusion: In this study,the competency model of assistant general practitioners in China was constructed for the first time,which can provide support for the improvement of the design of the national assistant general practitioner qualification examination,and provide a theoretical basis for the training and selection of assistant general practitioners.