转岗全科医生服务能力评价指标体系构建及应用研究

李妍君; 魏来; 范生根; 鲁晓慧; 程银霞; 陈文智

doi:10.16766/j.cnki.issn.1674-4152.002396

转岗全科医生服务能力评价指标体系构建及应用研究

doi: 10.16766/j.cnki.issn.1674-4152.002396

1.
遵义医科大学实验教学管理中心，贵州遵义 563000
2.
遵义医科大学管理学院
3.
西南医科大学学生工作部(处)，四川泸州 646000
4.
遵义医科大学外国语学院
5.
遵义医科大学管理学院
6.
毕节市医保局综合科，贵州毕节 551700

基金项目:

贵州省教育厅高校人文社会科学研究项目 CJ-2018-1

详细信息

通讯作者:
魏来，E-mail: weilaichn@aliyun.com

中图分类号: R197.323 R499
计量
- 文章访问数: 260
- HTML全文浏览量: 156
- PDF下载量: 20
- 被引次数: 0
出版历程
- 收稿日期: 2021-10-21
- 网络出版日期: 2022-08-20

Construction and application of the service performance evaluation index system for job-transfer general practitioners

1.
Experimental Teaching Management Center, Zunyi Medical University, Zunyi, Guizhou 563000, China

摘要

摘要: 目的基于转岗全科医生岗位胜任力要求构建转岗全科医生服务能力指标体系并作应用，为探索以能力为导向的全科医生转岗培训体系提供参考。方法运用文献法进行指标提取，采用两轮德尔菲法筛选和构建转岗全科医生服务能力评价指标体系，运用层次分析法确定指标权重。对构建指标采用目的性抽样调查150例转岗全科医生，统计分析选用描述性统计、t检验、方差分析。结果两轮专家咨询回收率分别为100.0%和94.1%；专家判断系数分别为0.977、0.931；熟悉系数分别为0.812、0.789；权威系数分别为0.895、0.860。第1轮和第2轮的专家协调系数分别为0.278(χ²=203.014, P < 0.001)、0.406(χ²=259.863, P < 0.001), 最终构建的指标体系包括一级指标3个，二级指标10个，三级指标28个。经信度检验，总指标Cronbach's α系数为0.973；因子分析作效度检验，提取3个主因子正交旋转，累计方差贡献率达到70.934%；问卷调查结果显示转岗全科医生基本能力掌握最佳，不同性别和不同职称的转岗全科医生能力自评总分差异有统计学意义(均P < 0.05)。结论本研究构建的转岗全科医生能力评价指标体系能为改进转岗全科医生培训、考核和评价提供较为客观、科学的参考依据。
- 转岗全科医生 /
- 核心能力 /
- 指标体系
Abstract: Objective To develop and apply the service performance evaluation index system for job-transfer general practitioners based on the post competency requirements of general practitioners, for providing a reference for the exploration of the capability-oriented training system for job-transfer general practitioners. Methods Literature review method was used to extract indexes, two rounds of Delphi method were adopted to screen and develop the service performance evaluation index system for the job-transfer general practitioners, and analytic hierarchy process was applied to determine the weights of indexes. A total of 150 job-transfer general practitioners were investigated by means of purposive sampling to construct indexes, and statistical analysis was then conducted in way of descriptive statistics and t-test, and analysis of variance. Results During the two rounds of expert consultations, the response rates were 100.0% and 94.1%; the judgement coefficients were 0.977 and 0.931; the familiarity rates were 0.812 and 0.789; and the authority rates were 0.895 and 0.860. The expert coordination coefficients for the first and the second consultations were 0.278 (χ²=203.014, P < 0.001) and 0.406 (χ²=259.863, P < 0.001), respectively. Finally, an index system was developed, consisting of 3 first-tier indexes, 10 second-tier indexes and 28 third-tier indexes. In terms of reliability test, the total index Cronbach ' s α coefficient was 0.973; in terms of validity test during factor analysis, three main factors were extracted for orthogonal rotation, and the cumulative variance contribution rate was 70.934%. The results of the questionnaire survey showed that the job-transfer general practitioners boasted of the best basic work competency, and there was a significant difference in the total competency self-assessment score of the general practitioners of difference genders and professional titles (all P < 0.05). Conclusion The service performance evaluation index system for job-transfer general practitioners developed in this study can provide objective and scientific reference basis and effective tools for improving the training, assessment and evaluation for the job-transfer general practitioners.
- Job-transfer general practitioners /
- Core competency /
- Index system

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图 1 转岗全科医生能力评价指标体系构建框架

Figure 1. Construction framework of competence evaluation index system of transferred general practitioners

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表 1 转岗全科医生服务能力评价指标体系及权重

Table 1. Evaluation index system and weight of service ability of transferred general practitioners

一级指标	权重	二级指标	权重	三级指标	权重
1.基本能力	0.568	1.1交流沟通能力	0.234	1.1.1与社区人群建立广泛联系的能力	0.156
				1.1.2化解冲突，说服与影响他人的能力	0.078
		1.2团队协作能力	0.106	1.2.1积极参与外部协作的能力	0.071
				1.2.2内部展现高度配合力	0.035
		1.3社区适应能力	0.061	1.3.1环境适应力	0.046
				1.3.2心理适应力	0.015
		1.4人文执业能力	0.166	1.4.1职业素养	0.056
				1.4.2人文关怀	0.111
2.专业能力	0.334	2.1基本医疗卫生服务能力	0.186	2.1.1基本临床医学知识学习力	0.053
				2.1.2全科临床思维能力	0.039
				2.1.3常见多发疾病的临床诊疗能力	0.075
				2.1.4常见基层急症快速处理技能	0.018
		2.2基本公共卫生服务能力	0.118	2.2.1为重点及特殊人群提供预防保健	0.022
				2.2.2健康教育与健康评估咨询技能	0.015
				2.2.3居民健康管理与慢病管理	0.018
				2.2.4社区康复与护理	0.012
				2.2.5实施以人为中心的健康照顾	0.042
				2.2.6应对突发公共卫生事件	0.009
		2.3社区卫生管理能力	0.030	2.3.1掌握管理学相关知识	0.004
				2.3.2医改政策制度落实	0.008
				2.3.3参与社区卫生管理活动	0.018
		2.4信息处理能力	0.020	2.4.1医学信息检索能力	0.004
				2.4.2医学信息分析能力	0.006
				2.4.3医学信息利用能力	0.010
3.拓展能力	0.098	3.1自主学习能力	0.067	3.1.1自我发展提升能力	0.050
				3.1.2持续学习行为能力	0.017
		3.2科学研究能力	0.012	3.2.1科技文献阅读运用能力	0.009
				3.2.2研究成果的转化能力	0.002

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表 2 转岗全科医生能力自评得分(x±s，分)

Table 2. Ability self-assessment score of transferred general practitioners (x±s, points)

一级指标	得分	二级指标	得分
基本能力	3.86±0.54	交流沟通能力	3.65±0.62
		团队协作能力	3.78±0.64
		社区适应能力	3.97±0.62
		人文执业能力	4.03±0.61
专业能力	3.59±0.59	基本医疗卫生服务能力	3.68±0.60
		基本公共卫生服务能力	3.57±0.62
		社区卫生管理能力	3.58±0.68
		信息处理能力	3.48±0.71
拓展能力	3.33±0.63	自主学习能力	3.66±0.65
		科学研究能力	2.99±0.86

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表 3 不同特征转岗全科医生能力自评得分比较(x±s，分)

Table 3. Comparison of ability self-assessment scores of general practitioners with different characteristics in post transfer (x±s, points)

项目	类别	人数	基本能力	专业能力	拓展能力	总分
性别	男性	86	3.95±0.51	3.73±0.51	3.47±0.55	3.72±0.47
	女性	64	3.74±0.55	3.39±0.63	3.13±0.67	3.42±0.56
t值			2.417	3.583	3.409	3.516
P值			0.017	< 0.001	0.001	0.001
年龄(岁)	< 20	1	4.25±0.00	3.88±0.00	3.00±0.00	3.71±0.00
	20~29	39	3.84±0.60	3.46±0.59	3.24±0.57	3.51±0.54
	30~39	76	3.88±0.54	3.63±0.63	3.35±0.67	3.62±0.56
	40~49	32	3.79±0.43	3.58±0.43	3.32±0.59	3.57±0.42
	≥50	2	4.50±0.71	4.31±0.44	4.25±0.35	4.35±0.50
F值			1.004	1.362	1.351	1.339
P值			0.408	0.250	0.254	0.258
学历	本科	80	3.95±0.54	3.65±0.63	3.39±0.65	3.66±0.55
	大专	55	3.76±0.53	3.49±0.54	3.20±0.59	3.48±0.50
	高中或中专	15	3.73±0.49	3.60±0.50	3.45±0.62	3.59±0.50
F值			2.622	1.137	1.921	1.915
P值			0.076	0.324	0.150	0.151
职称	无	35	3.69±0.59	3.34±0.62	3.13±0.62	3.39±0.55
	初级	92	3.94±0.51	3.66±0.57	3.40±0.59	3.67±0.50
	中级	18	3.65±0.42	3.51±0.40	3.11±0.61	3.42±0.42
	副高	4	4.31±0.48	4.22±0.57	4.19±0.75	4.24±0.57
	正高	1	4.25±0.00	3.94±0.00	3.75±0.00	3.98±0.00
F值			3.011	3.396	3.985	4.169
P值			0.020	0.011	0.004	0.003
工作年限(年)	≤5	52	3.90±0.58	3.53±0.66	3.30±0.61	3.57±0.56
	6~10	56	3.76±0.48	3.52±0.49	3.20±0.58	3.49±0.46
	11~15	11	4.15±0.55	3.77±0.72	3.45±0.80	3.79±0.62
	16~20	19	3.86±0.56	3.78±0.53	3.53±0.63	3.72±0.52
	≥21	12	3.88±0.54	3.69±0.60	3.58±0.70	3.72±0.56
F值			1.326	1.241	1.710	1.352
P值			0.263	0.296	0.151	0.254

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