基于健康中国背景下构建全科医学师资胜任力冰山模型

金丽娇; 刘伟荣; 龚海东; 吴越; 郭琳; 王俊林

doi:10.16766/j.cnki.issn.1674-4152.004386

基于健康中国背景下构建全科医学师资胜任力冰山模型

doi: 10.16766/j.cnki.issn.1674-4152.004386

1.
牡丹江医科大学公共卫生学院，黑龙江牡丹江 157011
2.
牡丹江医科大学离退休工作处
3.
牡丹江医科大学附属红旗医院神经外科，黑龙江牡丹江 157011
4.
牡丹江医科大学国际交流合作处
5.
牡丹江医科大学学生工作部(处)

基金项目:

黑龙江省省属高等学校基本科研业务费科研项目 2021-KYYWFMY-0070

详细信息

通讯作者:
王俊林，E-mail: myjwc_zs@163.com

中图分类号: R197.1 R192.3 R499
计量
- 文章访问数: 7
- HTML全文浏览量: 3
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-04-12
- 网络出版日期: 2026-04-11

Construction of iceberg model based on the post competency of general practitioner faculty under the background of healthy China

1.
School of Public Health, Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, China

摘要

摘要: 目的全科医学自80年代引入我国以来，已经取得了阶段性的发展，但目前我国尚缺乏统一完善的全科医学师资队伍建设体系，全科医学师资的岗位胜任能力尚未系统明确。本研究在“健康中国2030”背景下构建全科医学师资岗位胜任力模型，为现阶段全科医学师资队伍的标准化建设提供理论参考。方法通过查阅文献、半结构化访谈和专家咨询编制全科医学师资胜任能力特征调查问卷，采用探索性因子分析构建全科医学师资岗位胜任力模型，验证性因子分析进一步验证模型构建的科学性。结果构建的全科医学师资胜任力模型包括6个维度，30个胜任特征项，结果显示：χ²/df=1.769，P < 0.001，GFI=0.918，IFI=0.963，TLI=0.959，CFI=0.963，RMSEA=0.039，检验模型的拟合度良好，能较好地代表现阶段全科医学师资的胜任能力要素，较为全面地概括出健康中国背景下我国全科医学师资应具备的胜任能力。结论本研究构建的全科医学师资胜任力模型科学性和可行性较好，进一步丰富了全科医学师资队伍建设的理论基础，为全科医学师资的准入、培训及考核标准的制定提供参考依据，为全科医学师资队伍整体素质的提升提供有益参考，同时也对全科医学师资职业发展具有方向性的指导作用，明确能力提升的方向和目标。
- 健康中国 /
- 全科医学师资 /
- 岗位胜任力 /
- 冰山模型
Abstract: Objective Since its introduction to China in the 1980s, general practice has made significant progress. However, there is currently a lack of a unified and comprehensive system for the construction of general practice teaching faculty in China, and the post competency of general practice teaching faculty is not yet systematically defined. This study aims to construct a competency model for general practitioner faculty under the background of "Healthy China 2030", and providing theoretical reference for the standardization construction of the current general practitioner faculty. Methods A survey questionnaire on the competency characteristics of general practitioner faculty was developed through literature review, semi-structured interviews, and expert consultation. An exploratory factor analysis was used to construct a competency model for general practitioner faculty, and confirmatory factor analysis was used to further verify the construction of the model about the scientific and validity. Results The constructed competency model for general practitioner faculty included 6 dimensions and 30 competency feature items, the results showed that: χ²/df=1.769, P < 0.001, GFI=0.918, IFI=0.963, TLI=0.959, CFI=0.963, RMSEA=0.039, the validity of the model was good, and it could well represent the competency elements of current general practitioner faculty, and comprehensively summarized of the competencies that general practitioners in China should possess under the background of a healthy China. Conclusion The competency model for general practice faculty constructed in this study has good scientific and feasibility, further enriching the theoretical basis for the construction of the general practice faculty team, providing reference for the establishment of admission, training, and assessment standards for general practice faculty, and providing useful references for the overall quality improvement of the general practice faculty team. At the same time, it also has directional guidance for the professional development of general practice faculty, clarifying the direction and goals of ability improvement.
- Healthy China /
- General practitioner faculty /
- Post competency /
- Iceberg model

HTML全文

图 1 全科医学师资胜任力模型验证性因子分析路径图

Figure 1. Path diagram of confirmatory factor analysis for the competency model of general practitioners

下载: 全尺寸图片幻灯片

图 2 全科医学师资胜任力冰山模型

Figure 2. Iceberg model of general practitioner teacher competency

下载: 全尺寸图片幻灯片

表 1 探索性因子分析提取的各条目因子载荷结果

Table 1. Results of factor loadings extracted from exploratory factor analysis for each item

条目	因子载荷
条目	F1	F2	F3	F4	F5	F6
W11	0.502
W15	0.567
W19	0.586
W21	0.596
W22	0.724
W23	0.666
W26		0.674
W27		0.656
W28		0.609
W30		0.697
W31		0.635
W1			0.694
W2			0.683
W5			0.530
W7			0.506
W9			0.625
W10			0.617
W43				0.556
W44				0.709
W45				0.671
W46				0.592
W47					0.703
W48					0.552
W49					0.581
W50					0.540
W51					0.642
W32						0.608
W33						0.708
W34						0.626
W35						0.517

下载: 导出CSV

表 2 全科医学师资胜任力条目

Table 2. Competency items for general practitioner teachers

因子	胜任条目
教学知识	全科医学基本知识
	全科医学教育教学基本知识
	医患沟通技能
	全科医学诊疗理念
	人文知识
	临床知识与操作技能
教学能力	教学指导能力
	进行教学设计的能力
	良好的语言组织能力
	提供反馈
	鼓励学员反思
教学态度	引导学生开阔思路，启发学生创造力
	能够对学员进行个性化的培训
	对学员的学习过程持肯定、批判和开放的态度
	观察分析学员，与学员分享交流
	教学相长，从学员那里学习
	外出进修和学习
科研能力	科研思维训练指导
	科研、教学、实践研究能力
	跟踪学术前沿动态
	学术道德
职业素质	职业道德
	职业规划能力
	创新精神
	团队协作能力
	终身学习能力
人格特质	热情
	自我发展能力
	成就导向
	责任感

下载: 导出CSV

表 3 验证性因子分析模型拟合结果

Table 3. Confirmatory factor analysis model fitting results

统计量	χ²/df	RMR	RMSEA	GFI	AGFI	IFI	TLI	CFI
参照标准	< 5	< 0.05	< 0.08	>0.80	>0.80	>0.90	>0.90	>0.90
拟合指数	1.769	0.023	0.039	0.918	0.902	0.963	0.959	0.963

下载: 导出CSV

表 4 全科医学师资胜任力模型的信效度分析结果

Table 4. Reliability and validity analysis results of the competency model for general practitioners

统计量	F1	F2	F3	F4	F5	F6
AVE	0.630	0.652	0.397	0.495	0.443	0.438
CR	0.911	0.903	0.790	0.796	0.798	0.757
Cronbach's α	0.882	0.858	0.860	0.850	0.870	0.827

下载: 导出CSV

参考文献(18)

[1]	赵稳稳, 王荣英, 张金佳, 等. 全科医学师资质量评价体系建设研究进展[J]. 中国全科医学, 2024, 27(7): 784-788, 800. ZHAO W W, WANG R Y, ZHANG J J, et al. Advances in the construction of quality evaluation system for general practice faculty[J]. Chinese General Practice, 2024, 27(7): 784-788, 800.
[2]	陈华东, 廖晓阳, 刘长明, 等. 《健康中国行动(2019-2030年)》之重大专项行动核心要点解读与启示: 全科医生视角[J]. 中国卫生事业管理, 2020, 37(12): 958-960. CHEN H D, LIAO X Y, LIU C M, et al. Interpretation on the key points of major special initiatives in Health China Initiative (2019-2030) and enlightenment from it from the perspective of general practitioners[J]. The Chinese Health Service Management, 2020, 37(12): 958-960.
[3]	尤丛蕾, 姚弥, 齐建光. 全科医学师资对全科医学继续教育现状看法的定性研究[J]. 中国全科医学, 2021, 24(34): 4364-4371. YOU C L, YAO M, QI J G. General practitioner trainers' perspectives on continuing medical education in general practice in China: a qualitative study[J]. Chinese General Practice, 2021, 24(34): 4364-4371.
[4]	The Royal Australian College of General Practitioners. General practice: connecting the dots for students and junior doctors[EB/OL]. (2012-06-22)[2023-04-26]. http://www.Racgp.Org.au/download/Documents/Membership/connectil1hedots.pdf.
[5]	BLOUNT E, KIRBY-BLOUNT H, MOULTON L. The complete MRCGP casebook: 100 consultations for the RCA/CSA across the new 2020 RCGP curriculum[M]. CRC Press, 2021.
[6]	郭凌波, 常广明, 王永晨. 全科医学基层实践基地师资综合评价指标体系的构建[J]. 中华医学教育探索杂志, 2023, 22(10): 1483-1488. GUO L B, CHANG G M, WANG Y C. Construction of comprehensive evaluation index system for general practice teachers at grassroot practice bases[J]. Chinese Journal of Medical Education Research, 2023, 22(10): 1483-1488.
[7]	唐梦雅. 基于胜任力模型的人力资源管理策略[J]. 现代企业文化, 2024(12): 121-123. TANG M Y. Human resource management strategy based on competency model[J]. Modern Enterprise Culture, 2024(12): 121-123.
[8]	刘玲, 方金鸣, 彭义香. 全科医生岗位胜任力模型及理论的研究进展[J]. 中国临床研究, 2021, 34(11): 1565-1568. LIU L, FANG J M, PENG Y X. Research progress on competency model and theory of general practitioner positions[J]. Clinical Research in China, 2021, 34(11): 1565-1568.
[9]	方金鸣, 陶红兵, 彭义香, 等. 全科医生岗位胜任力模型构建[J]. 医学与社会, 2020, 33(1): 129-133. FANG J M, TAO H B, PENG Y X, et al. Construction of post competency model for general practitioners[J]. Medicine and Society, 2020, 33(1): 129-133.
[10]	张志远, 刘万芳, 张利岩, 等. 基于冰山模型及双螺旋模型构建医疗护理员培训师胜任力评价指标体系[J]. 护理研究, 2023, 37(4): 691-696. ZHANG Z Y, LIU W F, ZHANG L Y, et al. Construction of medical nurse assistant trainers' competency evaluation index system based on the iceberg model and double helix model[J]. Chinese Nursing Research, 2023, 37(4): 691-696.
[11]	杨敏. H公司猎头顾问岗位胜任力模型构建[D]. 上海: 上海财经大学, 2023. YANG M. Construction of the post competency model of headhunting consultant in H company[D]. Shanghai: Shanghai University of Finance and Economics, 2023.
[12]	宋小燕, 曾玟烨, 刘赣洪. 职前教师在线学习力模型构建研究: 基于探索性和验证性因子分析[J]. 六盘水师范学院学报, 2023, 35(1): 67-77. SONG X Y, ZENG W Y, LIU G H. Research on the construction of an online learning ability model for pre service teachers: based on exploratory and confirmatory factor analysis[J]. Journal of Liupanshui Normal University, 2023, 35(1): 67-77.
[13]	CHAN T E, LOCKHART J S, SCHREIBER J B, et al. Determining nurse practitioner core competencies using a Delphi approach[J]. J Am Assoc Nurse Pract, 2020, 32(3): 200-217. doi: 10.1097/JXX.0000000000000384
[14]	AN K, ZHANG R, ZHU B, et al. Familiarity of teaching skills among general practitioners transfer training trainers in China: a cross-sectional survey[J]. BMC Med Educ, 2023, 23(1): 949. DOI: 10.1186/s12909-023-04945-3.
[15]	梁黎明, 杜汋, 王延赏, 等. 紧急医学救援人员胜任力评价指标体系的构建研究[J]. 现代预防医学, 2020, 47(7): 1340-1344. LIANG L M, DU Y, WANG Y S, et al. Construction of the evaluation index system of emergency medical rescuers' competency[J]. Modern Preventive Medicine, 2020, 47(07): 1340-1344.
[16]	饶昕, 李双庆, 苏巧俐, 等. 医院-社区教学一体化背景下的基层全科师资能力指标体系研究[J]. 华西医学, 2021, 36(9): 1262-1266. RAO X, LI S Q, SU Q L, et al. Construction of the ability system of general practice tutors in grass-roots community training bases under the background of hospital-community teaching integration[J]. West China Medical Journal, 2021, 36(9): 1262-1266.
[17]	岳娜, 曹静敏, 陈文姬, 等. 江苏省全科师资培训医生职业吸引力与生命质量的现状及影响因素[J]. 中华全科医学, 2023, 21(1): 135-138, 153. YUE N, CAO J M, CHEN W J, et al. Status and influencing factors of career attractiveness and quality of life of general practitioner training doctors in Jiangsu Province[J]. Chinese Journal of General Practice, 2023, 21(1): 135-138, 153.
[18]	李嵘, 吴戈, 冯巩, 等. 全科医学生的专业认同感现状及其影响因素分析[J]. 中华全科医学, 2022, 20(1): 129-133. LI R, WU G, FENG G, et al. Professional identity and influencing factors amongst general practitioner students[J]. Chinese Journal of General Practice, 2022, 20(1): 129-133.