北京市乡村医生岗位胜任力模型的构建

李敏; 董玉祺; 李娜; 马力; 王晨; 刘艳丽; 孙晨; 王非; 王仲

doi:10.16766/j.cnki.issn.1674-4152.002798

北京市乡村医生岗位胜任力模型的构建

doi: 10.16766/j.cnki.issn.1674-4152.002798

李敏¹,
董玉祺²,
李娜³,
马力³,
王晨³,
刘艳丽³,
孙晨³,
王非¹,
王仲^1, ,

1.
清华大学附属北京清华长庚医院全科医学科清华大学临床医学院, 北京 102218
2.
南方医科大学南方医院惠侨医疗中心, 广东广州 510515
3.
首都医科大学附属北京天坛医院全科医疗科,北京 100070

基金项目:

首都全科医学研究专项课题项目 17QK17

首都卫生发展科研专项项目首发2016-3-2243

详细信息

通讯作者:
王仲, E-mail: wz523@mail.tsinghua.edu.cn

中图分类号: R197.6 R192.3
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- 文章访问数: 495
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- PDF下载量: 56
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-16
- 网络出版日期: 2023-04-07

Construction of the post competency model of rural doctors in Beijing

LI Min¹,
DONG Yu-qi²,
LI Na³,
MA Li³,
WANG Chen³,
LIU Yan-li³,
SUN Chen³,
WANG Fei¹,
WANG Zhong^{1
, ,}

1.
General Practice Department of Beijing Tsinghua University Affiliated Chang Gung Hospital, Tsinghua University Clinical School of Medicine, Beijing 102218, China

摘要

摘要: 目的构建北京市乡村医生岗位胜任力模型，为北京乡村医生的能力提升、成绩考核和培训提供可供参考的依据。方法采用文献研究法及专家小组讨论法构建岗位胜任力条目池及模型初稿，选择从事北京乡村医生研究的专家及直接从事乡村医生管理的基层医疗卫生管理人员18名，2019年5—9月运用改良的德尔菲专家咨询法通过邮箱发送2轮咨询表，对指标的重要性、适用性、可操作性进行评分，根据评分及专家意见修改北京市乡村医生岗位胜任力模型，运用层次分析法计算岗位胜任力模型各指标权重。结果经过2轮德尔菲专家咨询，2轮问卷专家的积极系数为100%，专家熟悉程度均值为0.87，判断依据均值为0.91，平均权威系数为0.89，最终确立的北京市乡村医生岗位胜任力模型，包括临床医疗服务能力、公共卫生服务能力、医学人文执业能力、教育与综合能力4个一级指标，8个二级指标及35个三级指标。计算各指标的权重，一级指标中临床医疗服务能力(0.374)及公共卫生服务能力(0.374)最高，二级指标中国家基本公共卫生服务(0.091)权重最高，三级指标中急、危、重症现场救护(0.021)和慢病管理权重(0.018)较高。结论通过改良的德尔菲法构建北京市乡村医生岗位胜任力模型,专家积极系数、权威系数较高,评价指标筛选科学合理,可作为评价北京市乡村医生胜任力的重要参考依据,但胜任力模型仍需根据乡村医生现状的发展不断修订完善。
- 北京市乡村医生 /
- 岗位胜任力 /
- 改良的德尔菲专家咨询法 /
- 层次分析法
Abstract: Objective To construct a model of rural doctors' post competency in Beijing, and provide a reference for the improvement of Beijing rural doctors' ability, performance evaluation and training. Methods Competency framework and model draft were build using a literature research method and expert group discussion method. A total of 18 experts who were either engaged in Beijing rural doctor research or directly engaged in rural doctor management were selected. From May to September 2019, the improved Delphi expert consultation method was used to send two rounds of consultation forms via email to score the importance, applicability and operability of the indicators. The post competency model of rural doctors in Beijing was modified according to the scores and expert opinions, and the weight of each indicator of the post competency model was calculated using the analytic hierarchy process. Results After two rounds of Delphi consultation, the positive coefficient of the two rounds was 100%, the expert' s familiarity with the topic was 0.87, their confidence of judgment was 0.91, making the average authority coefficient 0.89. The final establishment included four main areas, clinical medical service ability, public health service ability, medical humanities ability, education and other skills, with eight second-level indicators and 35 third-level indicators. The weight of each indicator was then calculated. In the first-level indicators, the highest scores were in clinical medical service capacity (0.374) and public health service capacity (0.374). Among the second-level indicators, the national basic public health service (0.091) had the highest weight. In the third-level indicators, urgent and severe on-site treatment (0.021) and chronic disease management (0.018) were the highest scoring. Conclusion The post competency model of rural doctors in Beijing is constructed through the improved Delphi method. The positive coefficient and authority coefficient of experts are high, and the selection of evaluation indicators is scientific and reasonable, which can be used as an important reference for evaluating the competency of rural doctors in Beijing. However, the competency model still needs to be constantly revised and improved according to the development of the current situation of rural doctors.
- Beijing rural doctor /
- Post competency /
- Improved Delphi method /
- Analytic hierarchy process

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表 1 18位专家基本信息调查表

Table 1. Questionnaire for basic information of experts

项目	类别	人数	百分比(%)
性别	男性	4	22.22
	女性	14	77.78
年龄(岁)	31~40	4	22.22
	41~50	11	61.11
	51~60	3	16.67
学历	本科	7	38.89
	硕士	3	16.67
	博士	8	44.44
来源	管理人员	8	44.44
	专家教授	10	55.56
工作年限(年)	10~20	10	55.56
	21~30	6	33.33
	31~40	2	11.11

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表 2 北京市乡村医生临床医疗服务岗位胜任力模型及权重

Table 2. Competency model and weight of rural doctors' clinical medical service positions in Beijing

指标	重要性
指标	x±s	满分比	变异系数	单层权重	组合权重
A临床医疗服务能力	4.89±0.47	94.44	0.10		0.374
A1基本临床诊疗技能	4.83±0.51	88.89	0.11	0.142	0.053
A1-1病史采集能力	4.72±0.75	83.33	0.16	0.091	0.005
A1-2规范的体格检查	4.72±0.75	83.33	0.16	0.091	0.005
A1-3疾病诊断与鉴别诊断	4.83±0.71	94.44	0.15	0.182	0.010
A1-4合理用药	4.89±0.32	88.89	0.07	0.217	0.012
A1-5常规诊疗操作技术	4.72±0.75	83.33	0.16	0.091	0.005
A1-6常用仪器设备操作能力	4.78±0.73	88.89	0.15	0.118	0.006
A1-7常见化验、辅助检查的判断与解读	4.78±0.65	88.89	0.14	0.118	0.006
A1-8门诊文书及文案资料的规范书写	4.67±0.77	77.78	0.17	0.091	0.005
A2综合医疗服务能力	4.83±0.51	88.89	0.11	0.142	0.053
A2-1首诊与转诊服务	4.67±0.59	72.22	0.13	0.138	0.007
A2-2家庭出诊及夜间诊疗	4.72±0.57	77.78	0.12	0.195	0.010
A2-3常见病、多发病的处理	4.78±0.73	88.89	0.15	0.276	0.015
A2-4急、危、重症现场救护	4.83±0.51	88.89	0.11	0.391	0.021

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表 3 北京市乡村医生公共卫生服务岗位胜任力模型及权重

Table 3. Position competency model and weight of rural doctors in public health service in Beijing

指标	重要性
指标	x±s	满分比	变异系数	单层权重	组合权重
B公共卫生服务能力	4.89±0.32	88.89	0.07		0.374
B1国家基本公共卫生服务	4.89±0.32	88.89	0.07	0.242	0.091
B1-1健康档案的建立使用和管理	4.83±0.38	83.33	0.08	0.144	0.013
B1-2健康教育	4.72±0.46	72.22	0.10	0.101	0.009
B1-3协助严重精神障碍患者管理	4.67±0.46	66.67	0.10	0.080	0.007
B1-4协助孕产妇健康管理	4.67±0.59	72.22	0.13	0.080	0.007
B1-5老年人健康管理	4.83±0.38	83.33	0.08	0.144	0.013
B1-6慢性病患者健康管理	4.89±0.32	88.89	0.07	0.196	0.018
B1-7传染病和突发公共卫生事件的报告与处理	4.83±0.51	88.89	0.11	0.144	0.013
B1-8卫生监督协管	4.61±0.61	66.67	0.13	0.064	0.006
B1-9协助儿童健康管理	4.56±0.7	66.67	0.15	0.046	0.004
B2其他公共卫生服务	4.61±0.61	66.67	0.13	0.077	0.029
B2-1协助家医签约	4.72±0.57	77.78	0.12	0.500	0.014
B2-2常用中医康复适宜技术	4.72±0.46	88.89	0.10	0.500	0.014

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表 4 北京市乡村医生医学人文执业岗位胜任力模型及权重

Table 4. Position competency model and weight of rural doctors in medical humanities practice in Beijing

指标	重要性
指标	x±s	满分比	变异系数	单层权重	组合权重
C医学人文执业能力	4.61±0.61	66.67	0.13		0.148
C1医患沟通能力	4.83±0.38	83.33	0.08	0.142	0.021
C1-1人文关怀能力	4.72±0.57	77.78	0.12	0.197	0.004
C1-2医患沟通技巧	4.83±0.51	88.89	0.11	0.332	0.007
C1-3积极预防医患矛盾	4.83±0.51	88.89	0.11	0.332	0.007
C1-4熟悉医疗纠纷的解决途径	4.67±0.77	77.78	0.17	0.139	0.003
C2医生职业精神与素养	4.83±0.51	88.89	0.11	0.142	0.021
C2-1职业道德与医德医风	4.83±0.51	88.89	0.11	0.234	0.005
C2-2依法行医	4.72±0.96	88.89	0.20	0.139	0.003
C2-3保护患者隐私权与知情权	4.89±0.47	94.44	0.10	0.393	0.008
C2-4患者满意度	4.83±0.38	83.33	0.08	0.234	0.005

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表 5 北京市乡村医生教育与综合岗位胜任力模型及权重

Table 5. Competency model and weight of rural doctors' education and comprehensive post in Beijing

指标	重要性
指标	x±s	满分比	变异系数	单层权重	组合权重
D教育与综合能力	4.44±0.78	55.56	0.18		0.105
D1教育学习能力	4.61±0.78	72.22	0.17	0.077	0.008
D1-1自我学习并运用基本医学知识	4.61±0.61	66.67	0.13	0.667	0.005
D1-2积极参加继续医学教育及培训进修学习	4.56±0.62	61.11	0.14	0.333	0.003
D2综合能力	4.22±1.06	50.00	0.25	0.035	0.004
D2-1组织协调能力	4.50±0.71	61.11	0.16	0.667	0.002
D2-2计算机操作与应用能力	4.39±0.61	44.44	0.14	0.333	0.001

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