An In-depth Study Of The Post Competency Index System Of Rural General Practice Assistant Physicians In China

Purpose:Through understanding the recognition degree of the competency index system of the grass-root rural doctors and the self-assessment based on this index system,we can further research the applicability and feasibility of the index system,in order to lay a strong foundation for the promotion and application of the index system.At the same time,based on this index system,analyzing the examination outline of rural general practitioners,discusses the comprehensiveness and rationality of its examination contents,and puts forward corresponding suggestions for the revision and improvement of the examination outline.Methods:This study uses stratified cluster sampling method to implement a nationwide survey of grass-root rural doctors.Through the analysis of the importance of the index system,we can understand the recognition of the index system by grass-roots rural doctors and test the applicability of the index system;Through the analysis of the post competency self-assessment of rural doctors based on this index system,we can understand the preliminary application of the index system and test the feasibility of the index system.By comparing the general practitioner index system with the rural general practitioner assistant index system,this paper discusses the content characteristics of the index system of rural general practitioners under the index system of general practitioners.By comparing the index system with the examination outline of rural general practitioners,this paper discusses the comprehensiveness and rationality of the examination outline,and puts forward corresponding modification suggestions.Results:The results of internal consistency test show that the overall Cronbach coefficient of the questionnaire is 0.986,and the Cronbach coefficient of the six first-level indexs is between 0.877-0.967,the reliability is good.The results of EFA showed that a total of 6 factors with eigenvalues greater than 1 were extracted,and the total variance explained was 69.38%.The statistical model obtained by CFA was similar to the theoretical model built by our team earlier,the model have a good structural validity.The results of CFA showed that χ2/df=5.870,RMSEA=0.069,RMR=0.023.CFI=0.858,IFI=0.858,PNFI=0.799,the six-factor model had a good fitness;The factor load is 0.633-0.874,AVE is 0.562-0.675,and CR is 0.878-0.969.The convergence validity is good.The analysis results of the recognition degree of the post competency index system show that the importance of first-level indexs is rated between 4.32 to 4.45,and the importance of second-level indexs is rated between 4.18 to 4.61,both of which are greater than 4 points.The index system is generally recognized by the grass-roots rural physicians,and the importance degree of the indexs at all levels is important.Among the first-level indexs,the highest recognition is professional quality,and the lowest recognition is information utilization ability and management ability.There are differences in the recognition of the index system among people with different working years,educational background,professional title and work unit.Educationgal background and professional titles are the influencing factors of the recognition degree of the index system.The analysis results of the current situation of post competency show that the self-evaluation scores of the first-level indexs are between 3.95-4.25,and the self-evaluation scores of the second-level indexs are between 3.74-4.36.Among the first-level indexs,the highest level of post competence is professional quality,and the lowest level of post competence is medical knowledge and lifelong learning;People with different working years,professional titles and working units have differences in the overall level of post competence;Educational background,professional title and work unit are the influencing factors of post competency level.The comparative analysis of the general practitioner competency index system and the rural general practitioner assistant competency index system shows that the first-level indexs in the two index systems are identical,and the second-level indexs are basically the same.Most of the contents of the general practitioner index system are reflected in the rural medical student index system.The rural doctor index system strengthens the requirements for the work content of the rural doctor.The comparative analysis of the index system and the examination outline shows that most of the contents of the index system are reflected in the examination outline to different degrees.The examination outline has a comprehensive and detailed investigation of basic medical knowledge and skills,but the investigation of"family-based continuous care","eugenics guidance" and other contents is not deep enough,and the investigation of professional quality is still lacking.Conclusions:1.Grass-root rural doctors recognized all indices,and the number of approved people in each index exceeded 80%of the total number.The competency index system of rural general practitioner assistant doctors was widely recognized by grass-roots rural doctors,and can be promoted and applied.2.The index system can be used as the basis for post competency evaluation and provide theoretical basis for the education and training of rural general practitioners.3.The index system can guide the revision of the qualification examination of rural general practitioners as well as the examination outline,which needs to be further improved in terms of the basic knowledge and communication skills of general practice.