Research On The Competency Evaluation Of Traditional Chinese Medicine (TCM) Physicians In County TCM Hospitals Of Hubei Province

[Purpose]Traditional Chinese Medicine(TCM) is superior resource of originality in China, and is our unique, indispensable and important health resource for our medical and health sector. Remaining the characteristic of TCM is an important strategic choice of the TCM hospitals for development. County hospitals of TCM play an irreplaceable role in rural tertiary health prevention and health care network, and are major medical institutions for TCM development and heritage. TCM personnel is the core resource for the TCM development. It is the key to select suitable TCM personnel, retain outstanding TCM talents, allocate TCM personnel rationally and encourage TCM talent effectively for sustainable development of county TCM hospitals with TCM characteristics. Our study evaluated comprehensively the competences of TCM physician in county TCM hospitals of Hubei Province in China with constructed TCM physician competency model, discussed the current problems of capacity-building aspects of TCM physician in county TCM hospitals and proposed the suggestions to improve the comprehensive ability of TCM physicians to enhance the advantage resources development of TCM in county TCM hospitals and improve the overall performance of county TCM hospitals.[Methods]1. Document retrieval and information analysis:Our study collected the domestic and foreign literatures, policy documents, annual reports and other relevant information and statistical data to understand the development condition, social status and related policy support of county TCM hospitals, development dilemma and competency requirements of TCM physicians, which are prepared for experts interview and TCM physician competency indexes designed.2. Expert consultation method:Through the interview and communication with the famous and old TCM scholars and experts, we modified and adjusted the content of designed TCM physician competency indexes, and selected and determinated the competency indexes in the TCM physician competency model.3. Spot investigation method:Through the investigation of447physicians (including139physicians in county TCM hospitals) in17TCM hospitals (including7county TCM hospitals) of5provinces in China and240TCM physicians in8county TCM hospitals of Hubei province, we understanded the current stutas of practicing environment and ability training of physicians, especially TCM physicians in county TCM hospitals, and collected relevant information about TCM physician competencies and evaluation with the method of informed semi-structured interviews, material collection and questionnaire survey.4. PEST analysis method:We analyzed systematically the macro environment of county TCM hospitals from political, economic, social and cultural, technical views, in order to further understand the practicing environment of TCM physicians in county TCM hospitals.5. Constructing competency model method:According to the classical theory of competency model and the relevant contents of "Global minimum essential requirements of medical education"(GMER), combined with TCM physicians’BEI interviews and experts’ advisory opinions, by means of internal consistency reliability test, principal component analysis and discriminant validity test of the TCM physicians competency factors, we constructed the competency model for TCM physicians in county TCM hospitals.[Results]1. We analyzed the current development difficulties of county TCM hospitals and obstacles to the development of TCM physicians from political, economic, social and cultural, technical views. We found that compared with the general hospitals, there have been some problems influencing the development of county TCM hospitals, such as the financial subsidies are not enough, the TCM policy support is not comprehensive, the characteristics of TCM is not very prominent, the TCM value is not fully reflected in current pricing system and so on. As the characteristics of TCM are hard to develop in county TCM hospitals, the TCM expertise and talent of TCM physicians can not be displayed, TCM diagnosis and treatment skills of TCM physicians are gradually weakened, which are not conducive to the development of TCM.2. Though the empirical investigation of the current stutas of TCM physicians practicing environment and ability training in county TCM hospitals, using the method of comparative analysis, we understanded that there had been problems of low income, not strong occupation identity, not enough ability training and so on for TCM physicians in county TCM hospitals, which would influence the enthusiasm of TCM physicians to provide TCM services and improve TCM diagnosis and treatment technology.3. We contructed TCM physician competency model, on the basis of "global minimum essential requirements in medical education"(GMER), combined with qualitative and quantitative analysis, and which is verified by the reliability and validity test method. The constructed TCM physician competency model are including7dimensions and41competence factors. So as we could consider the capacity building of TCM physicians in county TCM hospitals with comprehensive views.4. Through using the constructed TCM physician competency model, we evaluated the current competency status of TCM physicians in county TCM hospitals of Hubei Province. With the analysis, our study considered that we should pay more attention to cultivating medical ethics, standarding medical behaviors and improving the occupation value of TCM physicians; strengthen cultivating TCM mindset, teaching TCM classical theory and the whole TCM knowledge system; encourage TCM physicians using TCM technology for treatment at work and so on, in order to further promote the development of county TCM hospitals with TCM characteristics and the development of TCM in rural areas.5. On the basis of TCM physician competency model, Our study put forward different evaluation methods and suggestions to identify the qualified TCM physician and outstanding TCM physician in county TCM hospitals, which could be used for all aspects of TCM physician management (including TCM personnel planning, selection, training, performance management and salary management etc.). [Conclusions]On the basis of theoretical analysis and empirical studies, we constructed the TCM physician competency model in county TCM hospitals according to three-dimensional modeling method of "quality features+expert advice+questionnaire+verification". And then we evaluaed the competences of the TCM physician in county TCM hospitals of Hubei Province using the constructed TCM physician competency model, and explored the existing problems associated with the capacity-building aspects of TCM physician in county TCM hospitals. At last, we proposed the related suggestions including creating a good practicing environment for TCM physicians to enhance their abilities, improving evaluation system of TCM physicians in county TCM hospitals, promoting the transformation of TCM physicians management mode, strengthening the development with characteristics of TCM in county TCM hospitals, promoting the reform of medical and health system and so on, which would help enhance the abilities of TCM physician, promote the development of superior resources and improve overall performance in county TCM hospitals.[Innovation and Deficiency]In our study, competency theoretical model was used to improve TCM physician competences in county TCM hospitals, which is with some theoretical innovation. And we explored to construct TCM physician’s competency model, which could be used in all aspects of the management of TCM physicians, in order to improve the overall competences, especially Chinese medical skills of TCM physicians in county TCM hospitals, which is with some practical innovation. However, due to limited samples and subjective evaluation method was used, the application of the constructed model requires further research and verification.