中国全科医学 ›› 2023, Vol. 26 ›› Issue (04): 460-466.DOI: 10.12114/j.issn.1007-9572.2022.0376

• 论著·全科医生岗位胜任力专题研究 • 上一篇    下一篇

签约服务情境下基于扎根理论的全科医生胜任力模型构建研究

马志强, 郭乐*(), 李钊, 葛柏麟   

  1. 212013 江苏省镇江市,江苏大学管理学院
  • 收稿日期:2022-06-06 修回日期:2022-10-23 出版日期:2023-02-05 发布日期:2022-12-02
  • 通讯作者: 郭乐
  • 马志强,郭乐,李钊,等.签约服务情境下基于扎根理论的全科医生胜任力模型构建研究[J].中国全科医学,2023,26(4):460-466,485.[www.chinagp.net]
    作者贡献:马志强负责总体研究目标的制定,文章的构思、设计与指导,为研究课题提供资金支持,并对文章进行监督与管理;郭乐进行资料收集与整理,撰写并修订论文,对文章整体负责;李钊、葛柏麟参与文章的修订、质量控制与审校。
  • 基金资助:
    国家自然科学基金面上项目——全科医生胜任力与居民签约服务利用意愿的耦合机制及提升策略研究(71974082); 国家自然科学基金面上项目——全科医生服务价值实现的机理与策略研究(71573109); 江苏大学第19批大学生科研课题立项资助项目(19C292); 江苏大学第20批大学生科研课题立项资助项目(20C445)

Development of the General Practitioner Competency Model Using Grounded Theory for Assessing General Practitioners' Competencies in Delivering Contracted Care Services

MA Zhiqiang, GUO Le*(), LI Zhao, GE Bailin   

  1. School of Management, Jiangsu University, Zhenjiang 212013, China
  • Received:2022-06-06 Revised:2022-10-23 Published:2023-02-05 Online:2022-12-02
  • Contact: GUO Le
  • About author:
    MA Z Q, GUO L, LI Z, et al. Development of the general practitioner competency model using grounded theory for assessing general practitioners' competencies in delivering contracted care services[J]. Chinese General Practice, 2023, 26 (4) : 460-466, 485.

摘要: 背景 当下医疗卫生资源存在"供需错配"现象,落实家庭医生签约服务是突破困境、完善分级诊疗体系建设的有力抓手,因此加快全科医生队伍建设并确保培养质量成为当务之急。 目的 探讨签约服务情境下全科医生胜任力的概念及其结构维度,挖掘胜任力的隐性部分,以构建系统且全面的全科医生胜任力模型,为全科医生培养的"量质并举"和签约服务的"提质增效"提供参考。 方法 于2020年12月至2021年9月,对江苏省镇江市、泰州市、苏州市和广东省佛山市10所基层医疗卫生机构的38位提供签约服务的全科医生进行半结构化访谈。依据扎根理论对访谈数据进行三级编码分析,并进行理论饱和度检验,以构建全科医生胜任力模型。 结果 签约服务情境下全科医生胜任力模型由全科服务能力、人文执业能力、团队协作能力、学习发展能力4大维度、10项胜任特征构成。其中,全科服务能力和学习发展能力是全科医生胜任力的外在表现和外在驱动,属于胜任力的外显层面,决定了全科医生提供签约服务的能力水平;人文执业能力和团队协作能力是全科医生的内在特质与能力,属于胜任力的内隐层面,决定了全科医生提供签约服务的能力潜质。 结论 本研究充分挖掘胜任力的内隐层面,构建出完整且全面的全科医生胜任力模型,可为签约服务情境下全科医生的培养提供参考,也可为后续运用量化实证研究方法建立全科医生胜任力评价体系奠定基础。

关键词: 全科医生, 岗位胜任力, 胜任力模型, 家庭医生签约服务, 质性研究, 扎根理论

Abstract:

Background

There is an issue of mismatch between supply and demand of medical care resources in China. The implementation of contracted family doctor services is an effective measure to address the issue, and to improve the hierarchical diagnosis and treatment system. Therefore, it is urgent to speed up the training and ensure the training quality of general practice workforce.

Objective

To develop a comprehensive and systematic general practitioner (GP) competency model after analyzing the concept and structural domains of competencies (including inner competencies) required for GPs to deliver contracted healthcare services, providing insights into the realization of training eligible GPs in terms of quantity and quality, and the improvement of quality and efficiency of contracted services.

Methods

From December 2020 to September 2021, we conducted in-depth, semi-structured interviews with 38 GPs from 10 medical institutions in four cities (Zhenjiang, Taizhou and Suzhou in Jiangsu Province, and Foshan in Guangdong Province) , then treated the interview results applying the three-level coding and theoretical saturation used in the grounded theory. After that, we developed a General Practitioner Competency Model.

Results

The model consists of 10 items, which belong to four domains: general care capability, humanistic practice capability, team cooperation capability, learning and development capability. General care capability and learning and development capability belong to external competencies, which represent the external performance and driving force of competencies, and determine the level of competencies of GPs to provide contracted services. Humanistic practice capability and team cooperation capability reflect the internal traits and competencies, which belong to the inner competencies, and determine the potential of GPs to provide contracted services.

Conclusion

The model developed by us is complete and comprehensive, in which the inner competencies of GPs have been fully explored, which may be contributive to the training of GPs delivering contracted services, and to the development of a GP competency assessment system using quantitative empirical methods.

Key words: General practitioners, Competency, Competency model, Contracted family doctor services, Qualitative research, Grounded theory