Research On The Competency Model Construction Of Public Health Physicians In Maternity And Child Healthcare Institutions

[Purpose]This study aims to construct a post competency model for public health physicians working in maternity and child healthcare institutions,and conduct an in-depth analysis of the influencing factors of the competency importance score,put forward countermeasures and suggestions based on the key influencing factors,and explore the popularization and application of the model,with a view to promoting training of public health personnel in medical schools,management of public health personnel in maternity and child healthcare institutions,and personal career planning of public health physicians.[Methods](1)By consulting relevant literature and policy documents,initially draft a pool of competency items.(2)Through expert consultation and special discussion methods,delete and merge related items,obtain the final competency conceptual model containing 57 competency items and 8 sub-dimensions: comprehensive professional knowledge,maternal and child related knowledge,emergency response skills,daily work skills,communication skills,scientific research capabilities,personal qualities,and professional values.And calculate the expert’s enthusiasm,authority and opinions coordination to evaluate the reliability of experts.(3)Five public health-related departments of a maternity and child healthcare institution were selected for pre-investigation,and 3 items were deleted based on the statistical analysis results to form the final questionnaire on the competency of public health physicians in maternity and child healthcare institutions,with 54 items in total.(4)A cluster survey was conducted on the staff of the public health related departments of 3 maternity and child healthcare institutions in Shenzhen(excluding those who did not conform to the definition of public health physicians in this study),totaling 350.Use Cronbach’s ? coefficient to test the reliability of the questionnaire,use the correlation analysis method to test the content validity of the questionnaire,use the factor analysis method to test the structural validity of the questionnaire,and use the structural equation model to evaluate and modify the post competency model of public health physicians in maternity and child healthcare institutions,and analyze its path relationship.(5)Descriptive statistical analysis,one-way ANOVA and multivariate Logistic regression were used to analyze the status quo of competency importance score and its influencing factors.[Results](1)Combine the iceberg model,onion model and KSAOs theory to form a conceptual model that includes 4 core dimensions of theoretical knowledge,work skills,comprehensive ability,and personal traits,and 80 competency items.(2)A total of 12 experts and scholars in the field of public health were issued expert consultation forms,the effective recovery rate was 100%,and the degree of enthusiasm,authority and coordination of opinions of experts was high,among which the authority coefficient was 0.80 and the coordination coefficient was 0.381.(3)A total of 335 questionnaires were collected,of which 326 were valid questionnaires,with an effective rate of 97.31%.The Cronbach’s ? coefficient of the total questionnaire is0.921,which is greater than 0.8,and the reliability is good.The KMO value of the total questionnaire is 0.889,and the approximate chi-square value of the Barlett sphere test result is 1102.764(P<0.001),and the validity is good.(4)After modified the structural equation model,the fitting indexes of each dimension and the final model reach the fitting standard,the final model of the fitting indexes are:chi-square/df(2.105),RMSEA(0.076),NFI(0.919),GFI(0.934),AGFI(0.895),RFI(0.871),IFI(0.923),TLI(0.931),CFI(0.942),the model can well represent the competence of public health physicians in maternity and child healthcare institutions.The results of the structural equation model show that,from high to low,the load of each factor of the competence of public health physicians is: personal quality(0.94),professional values(0.93),organization and collaboration ability(0.87),knowledge transformation and scientific research ability(0.76),maintain health skills for women and children(0.64),emergency response skills(0.63),clinical expertise(0.61),and maternal and child related knowledge(0.46).(5)Competency factors with higher scores are routine health care services for women and children,rigorous work,and problem-solving ability,while the lower ones are women and children’s health monitoring and evaluation interventions,health management related knowledge,and basic management knowledge.From high to low,the competency scores of the four major sectors are "work skills","personal characteristics","comprehensive ability",and "theoretical knowledge".(6)The results of one-way ANOVA showed that demographic variables such as gender,age,unit,position,education,major,qualification certificate acquisition,etc.had a significant impact on the competency score;the results of multivariate Logistic regression analysis showed that junior college degree and below,clinical medicine relevant majors and failure to obtain public health doctor qualification certificates are negatively correlated with the survey respondents’ total competency scores.[Conclusions](1)The final competency index system for public health physicians in maternity and child healthcare institutions includes 4 core dimensions,8 sub-dimensions and 48 items.(2)The established competency model is scientific,applicable and innovative,and can be used to evaluate the post competence of public health physicians in maternity and child healthcare institutions for reference by other institutions.(3)Explore the application of the competency model for public health physicians in maternity and child healthcare institutions,which will help medical schools to update the knowledge system and practical courses of public health professions,and promote maternity and child healthcare institutions to improve public health physicians recruitment selection standards,job training system,performance appraisal system and feedback mechanism.In addition to helping public health physicians formulate a reasonable career development plan.