全科医生岗位胜任力评价指标体系的实证研究  

Empirical Research of the Evaluation Index System of Post Competence of General Practitioners

作　　者：韩颖[1] 王晶[2] 郑建中[3] 程景民[1] 李建涛[1] 李菲[1] 张持晨[1] 

机构地区：[1]山西医科大学管理学院,山西省太原市030001 [2]山西医科大学公共卫生学院,山西省太原市030001 [3]长治医学院,山西省长治市046000

出　　处：《中国全科医学》2017年第4期399-405,共7页Chinese General Practice

基　　金：教育部人文社会科学研究规划基金项目(13YJA630027);山西医科大学关于2015年校级教育教学改革招标重点项目(201502)

摘　　要：目的评价前期已构建的全科医生岗位胜任力评价指标体系(指标体系)的信度、效度及区分度。方法于2015年12月—2016年2月,采用方便抽样方法在太原市抽取28家社区卫生服务中心/站的全科医生150例进行问卷调查。问卷内容分为全科医生基本情况和前期通过专家咨询法构建的指标体系自评满意度两个部分,共发放问卷150份,回收有效问卷145份,有效回收率为96.7%。采用Cronbach'sα系数、因子分析以及秩和检验分别验证指标体系的信度、效度、区分度。结果总体指标体系的Cronbach'sα系数为0.982,其中一级指标(基本医疗服务能力、公共卫生服务能力、人文执业能力、教育学习能力)的Cronbach'sα系数分别为0.960、0.960、0.926、0.918。总体指标体系与一级指标的相关系数分别为0.911、0.899、0.748、0.793;探索性因子分析共提取了4个共同因子,累积方差贡献率为67.035%;基本医疗服务能力除标注拟合指数(NFI,0.792)、拟合优度指数(GFI,0.695)外,其余拟合度指标〔残差均方和平方根(RMR,0.097)、增值拟合指数(IFI,0.838)、Tucker-lewis指数(TLI,0.813)、比较拟合指数(CFI,0.837)、简约拟合优度指数(PGFI,0.550)、简约标准拟合指数(PNFI,0.692)、卡方自由度比(χ~2/df,3.760)〕均达到评价标准;公共卫生服务能力除RMR(0.110)、GFI(0.719)外,其余拟合度指标〔NFI(0.812)、IFI(0.850)、TLI(0.818)、CFI(0.849)、PGFI(0.531)、PNFI(0.674)、χ~2/df(4.196)〕均达到评价标准;人文执业能力除RMR(0.106)、GFI(0.799)外,其余拟合度指标〔NFI(0.853)、IFI(0.884)、TLI(0.842)、CFI(0.883)、PGFI(0.509)、PNFI(0.634)、χ~2/df(4.150)〕均达到评价标准;教育学习能力除PGFI(0.335)、PNFI(0.469)、χ~2/df(8.330)外,其余拟合度指标〔RMR(0.090)、GFI(0.853)、NFI(0.896)、IFI(0.907)、TLI(0.821)、CFI(0.906)〕均达到评价标准,拟合效果较为理想。高分组总体指标体系及基本医疗服务能力、公共卫生服务Objective To evaluate the reliability,validity and discrimination of the early constructed evaluation index system（Index System） of post competence of general practitioners. Methods From December 2015 to February 2016,150 general practitioners from the 28 community health service centers / stations selected from Taiyuan by convenience sampling method were interviewed with questionnaires. The contents of the questionnaires included the basic situation of general practitioners and the self-evaluation satisfaction of the Index System constructed by expert consultation method in the early stage,150 questionnaires were sent out,145 valid questionnaires were collected and the effective response rate was 96. 7%. Cronbach＇ s α coefficient,factor analysis and rank sum test were used to verify the reliability,validity and discrimination of the Index System. Results The overall Cronbach＇s α coefficient of the Index System was 0. 982,of which the Cronbach＇s α coefficients of the first-grade indexes（basic medical service ability,public health service ability,humanistic professional ability,education and learning ability）were 0. 960,0. 960,0. 926,and 0. 918 respectively. The correlation coefficient between the overall Index System and the first-grade indexes were 0. 911,0. 899,0. 748,and 0. 793 respectively; four common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 67. 035%; except for the labeled normed fit index（NFI,0. 792）,the goodness of fit index（GFI,0. 695） in the basic medical service ability,the rest degree of fitting indexes 〔residual mean square and square root（RMR, 0. 097）, incremental fit index（IFI, 0. 838）, Tucker-lewis index（TLI, 0. 813）,comparative fit index（CFI,0. 837）,parsimony goodness of fit index（PGFI,0. 550）,parsimony normed fit index（PNFI,0. 692）,and the ratio of chi-square and degrees of freedom（χ2/ df,3. 760） 〕had all reached the evaluation standard; except for RMR（0. 110）,GFI（0. 719

关 键 词：全科医生 岗位胜任力 评价指标体系 实证研究 

分 类 号：R197[医药卫生—卫生事业管理]