中国乡村全科执业助理医师岗位胜任力指标体系的初步应用效果分析  

Application feasibility of the post competency index system of rural general practice assistant physicians

作　　者：高晗 张鑫岩 徐沙沙 宫雪[3] 张旭 李一萱 于晓松[1] Gao Han;Zhang Xinyan;Xu Shasha;Gong Xue;Zhang Xu;Li Yixuan;Yu Xiaosong(Department of General Practice,the First Affiliated Hospital of China Medical University,Shenyang 110001,China;Department of Gastroenterology,the Fourth Affiliated Hospital of China Medical University,Shenyang 110032,China;the Library of China Medical University,Shenyang 110122,China;Office of Science and Education,Chaoyang Central Hospital,Chaoyang 122099,China)

机构地区：[1]中国医科大学附属第一医院全科医学科,沈阳110001 [2]中国医科大学附属第四医院消化内科,沈阳110032 [3]中国医科大学图书馆,沈阳110122 [4]朝阳市中心医院科教科,朝阳122099

出　　处：《中华全科医师杂志》2024年第2期132-139,共8页Chinese Journal of General Practitioners

基　　金：国家医学考试中心项目(222-2100019002)。

摘　　要：目的研究乡村全科执业助理医师岗位胜任力指标体系可行性,分析并比较不同特征乡村全科执业助理医师的岗位胜任力。方法该研究为横断面调查。2020年10月—2021年9月,采用分层整群抽样的方法对我国10个省/直辖市的乡村全科执业助理医师进行岗位胜任力问卷调查,分析乡村全科执业助理医师基于指标体系的岗位胜任力自评得分情况,并比较不同特征乡村全科执业助理医师的岗位胜任力自评得分差异。结果共发放问卷1123份,回收有效问卷1024份,问卷有效回收率91.2%。有效回答问卷的乡村全科执业助理医师中,男性占51.7%(529/1024),40~49岁者占42.5%(435/1024),高中/中专及以下学历者占42.4%(434/1024),初级职称者占51.9%(531/1024)。问卷总体的Cronbach′sα系数为0.987,6项一级指标的Cronbach′sα系数在0.897~0.974之间;探索性因子分析的累计方差贡献率为72.012%;验证性因子分析结果为:χ2/df=3.926,近似误差均方根(RMSEA)=0.076,比较拟合指数(CFI)=0.858,增值拟合指数(IFI)=0.859。1024名乡村全科执业助理医师岗位胜任力6项一级指标的自评平均分为3.95~4.25分,60项二级指标的自评平均分为3.74~4.36分。不同工作年限、职称、工作单位和经济区域的乡村全科执业助理医师岗位胜任力自评得分差异有统计学意义(F=4.67、10.54、22.16、20.90,均P<0.05)。工作年限10~19年者岗位胜任力自评得分最低(均P<0.05);初级职称者岗位胜任力自评得分最高,中级及以上职称者岗位胜任力自评得分最低(均P<0.05);在村卫生室工作者岗位胜任力自评得分最高,在社区卫生服务中心工作者岗位胜任力自评得分最低(均P<0.05);位于东部地区者岗位胜任力自评得分最低(均P<0.05)。结论乡村全科执业助理医师岗位胜任力指标体系具有良好的可行性,可以用于岗位胜任力的评价,为乡村全科执业助理医师的培养考核提供依据。Objective To evaluate the application feasibility of the post competency index system of rural general practice assistant physicians,and to analyze and compare the post competency of rural general practice assistant physicians with different characteristics through a survey among rural general practice assistant physicians in China.Methods This study was a cross-sectional study.A questionnaire survey was conducted among rural general practice assistant physicians in 10 provinces/municipalities selected by stratified cluster sampling method from October 2020 to September 2021.The post competency scores were self-evaluated based on the post competency index system of rural general practice assistant physicians.The results of the survey were analyzed and the application feasibility of the index system was evaluated.Results A total of 1123 questionnaires were distributed and 1024 valid questionnaires were returned with a recovery rate of 91.2%.Of the 1024 respondents,529 were males(51.7%),435 were aged 40-49 years(42.5%),434 had a secondary school education or less(42.4%),and 531 were junior practitioners(51.9%).The Cronbach′sαcoefficient of the overall questionnaire was 0.987,and the Cronbach′sαcoefficient of the first level index ranged from 0.897 to 0.974.The cumulative variance contribution rate of exploratory factor analysis was 72.012%.The confirmatory factor analysis showedχ2/df=3.926,RMSEA=0.076,CFI=0.858,IFI=0.859,indicating that the model fit was basically good.The average self-evaluation scores of the first level index ranged from 3.95 to 4.25,and the average self-evaluation scores of the second level index ranged from 3.74 to 4.36.There were significant differences in self-evaluation scores of post competency among rural general practice assistant physicians with different working years,professional titles,working units and economic regions(F=4.67,10.54,22.16 and 20.90,all P<0.05).People with low self-evaluation scores of post competency had the following characteristics:working 10-19 years,interme

关 键 词：全科医生 农村地区 岗位胜任力 问卷调查 

分 类 号：C975[经济管理—劳动经济] R-4[医药卫生]