Page 110 - 中国全科医学2022-07

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7.Jiangning Subdistrict Community Health Center，Jing'an District，Shanghai 200041，China
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Corresponding author：YU Dehua，Professor，Chief physician，Doctoral supervisor；E-mail：ydh1404@sina.com
【Abstract】 Background The general practice team leader is not only a community health practitioner，but also a
manager，commander and coordinator of a general practice team. So choosing an eligible person for the post of general practice
team leader is of primary importance. Objective To develop and verify a competency evaluation system for general practice team
leaders，providing a reference for scientifically assessing the competencies of a general practice team leader，and for selecting an
eligible person as a general practice team leader. Methods By use of literature review and semi-structured reviews，we collected
data regarding competencies for an eligible general practice team leader，and used them to initially develop a competency
evaluation system for general practice team leaders. Then from July to October 2020，we conducted a three-round Delphi survey
with a purposive sample of 20 experts（in the field of general medicine，medical education，public health management，or
administrative management）to improve the system，and assess the indicators of the system using the analytic hierarchy process，
and test the logic consistency among indicators，then the final system was formed. To assess values of the three-level indicators
in the system，from November 1 to 30，2020，we carried out a survey on wjx.cn（an online questionnaire survey platform）
using a self-administered questionnaire developed by us，and selected a stratified random sample of 32 cases（16 directors of
community health centers，and 16 general practice team leaders from 8 central urban districts of Shanghai）to anonymously
complete the survey via scanning the WeChat RQ code using a mobile phone or computer. The survey data were collected to input
into a database，and analyzed for understanding the inter-rater differences in the importance of the top 15 indicators. Results
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The response rate，authority coefficient，and Kendall's W were 90.0%，0.912，and 0.183（χ =42.516，P<0.001）
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respectively，for the first round of survey，95.0%，0.933，and 0.359（χ =68.937，P<0.001）respectively，for the second
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round of survey，and 100.0%，0.940，and 0.516（χ =87.329，P<0.001），respectively，for the third round of survey. The
final system is composed of 5 first-level indicators，17 second-level indicators and 43 third-level indicators. The weights for
the 5 first-level indicators were 0.344，0.222，0.192，0.137 and 0.105，respectively. The consistency ratios for hierarchical
arrangement of indicators were all <0.1. Among the top 15 third-level indicators in terms of importance，except for the importance
of "the ability to provide referral services"，and "the ability to assist in the handling and management of public health events"，
the importance of other 13 indicators rated by directors of community health centers and general practice team leaders showed
no significant differences （P>0.05）. Conclusion The system developed by us has high scientificity and practicability with a
rational structure and well-targeted indictors，which may be used as a tool for the selection and training of general practice team
leader.
【Key words】 General practice team leader；Job competence；Evaluation；Index system；Construction and
application

“胜任力”这一概念最早由哈佛大学教授戴维·麦
本文要点及研究意义：
克利兰于 1973 年正式提出，是指在特定工作岗位和组
基层医疗卫生机构全科团队长的选拔和培养是一
织环境中能显著区分卓越成就者与普通者的个人的深层 个难题。目前，对于全科团队长岗位胜任力标准 , 多
次特征 ［1］ 。只有具备与组织战略目标和岗位要求相匹
仅有原则性规定，缺乏细化指标。而我国全科团队长
配的胜任力特征，才能高效地发挥经营管理才能，实现
的选拔又主要以年资和职称为依据，“论资排辈”一
组织的长远目标。全科团队是社区卫生的服务单元。全
定程度上会导致团队活力、工作效率低下。本研究通
科团队长是整个全科团队的核心与骨干，在维护社区居
过文献分析、半结构化访谈、专家函询、层次分析等
民健康、提高全科团队的服务质量和运行效率中起着至 方法，构建了由 5 个一级指标、17 个二级指标及 43
关重要的作用 ［2］ 。作为全科团队长不仅要牢固掌握专
个三级指标构成的全科团队长岗位胜任力评价指标体
业知识、拥有精湛的医疗技术，更需要具备包括领导
系，并采用问卷调查法对其适用性进行了初步验证。
力、综合管理能力、人文能力和创新突破能力等在内的
构建的全科团队长岗位胜任力评价指标体系主题明
综合素质能力。但目前，对于全科团队长岗位胜任力标
确、内容丰富、层次清晰，具有新颖性、科学性和实
准 , 多仅有原则性规定，缺乏细化指标。此外，由于不
用性。该体系不仅有助于推进全科团队长选拔 / 聘用
同的全科医生在年龄、学历、职称、专业背景、擅长领
制度的建立和完善，还可以助力人才培养与评价工作。
域和专业技能水平等方面存在差异，且在不同的核心能
同时，全科团队长也可以利用该指标体系及时发现和
力上也各有高低，具备哪些关键能力、素质或特质（征）
解决自身存在的问题，不断完善自我。
对于胜任全科团队长工作更为重要仍存在争议。总体而