| Objectives 1.To define a post competency model of rural order-oriented general practitioners under the purpose of providing a systematical tool for evaluating the quality and effect of Chinese "5+3" rural order-oriented general practitioners training program.2.To evaluate the current situation of post competency of "5+3" rural order-oriented general practitioners in Guangxi,and further explore the influencing factors of competency building.3.Put forward countermeasures and suggestions for improving post competency from the micro,meso and macro aspects guiding by the ecosystem perspective based on the result of SWOT analysis about current situation and influencing factors of post competency.High-performing general practitioner is a crucial part of primary health care,which plays a very crucial role in achieving the goal of Health China2030.Focusing on the post competency rather than ability evaluation,this study defined the evaluation model and index system from the post-required perspective.Qualitative and quantitative methods were both used in this study to guarantee the scientific and practical level for further evaluating the post competency of "5+3" rural order-oriented general practitioners.Based on the evaluation result of current situation and influencing factors,countermeasures and suggestions of improving post competency can be put forward more specificly.Methods A multistage process was adopted to develop the post competency model,including literature review,modified Delphi process,questionnaire and SWOT analysis.36 experts participated in 2-round Delphi process following by Analytic Hierarchy Process.The questionnaire on the current situation of post competency designed as Likert 5-level scale was completed by self-evaluation of 409 "5+3" rural order-oriented general practitioners within Guangxi.Reliability and validity analysis,single factor analysis,multi-factor analysis and SWOT analysis were applied in this study.Results The developed post competency model and evaluation index system included 6 domains(basic medical service ability,public health service ability,humanistic practice ability,interpersonal communication ability,education and learning ability,and comprehensive management ability),11 secondary indicators,and 39 tertiary indicators.393 completed questionnaires(97.28%)were returned.Pearson correlation analysis and exploratory Factor analysis supported the construct validity.Good reliability was supported by internal consistency reliability(Cronbach’s α= 0.935).The results of the evaluation of the current situation of competency showed that the respondents were relatively satisfied with the overall post competency.The self-assessment scores arranged from the top to the bottom were humanistic practice ability,interpersonal communication ability,basic medical capacity,public health capacity,education and learning capacity and general management capacity.In general,influencing factors included political appearance,service time,and position level;besides,ethnicity,gender,average daily working hours and graduation institutions were the influencing factors of job competency in different domains.P<0.05.Conclusions The post competency model was developed from the WONCA tree model,defied by the requirement of local “5+3” rural general practitioners in western China.The overall reliability and validity of the competency model were good.The self-assessment results on the current situation of post competency showed that although the overall evaluation was satisfied,the general management capacity and educational learning capacity dimension were comparatively weak with the probable reason of imperfection questionnaire.The analysis of the influencing factors suggests that the effect of standardized training,emphasis on ideological and political education,strengthening party building,increasing practice time in rural environment,and opening up promotion channels might help improve the post competency. |
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