全科医师规范化培训考核指标体系的构建

摘要

目的：建立全科医师规范化培训考核指标体系，以统一培训考核标准，保证培训质量。方法于2014年3月—2015年3月在天津市全科医师规范化培训临床基地和社区基地选取全科医学领域专家30例。根据德尔菲法的实施程序，采用发送电子邮件的方式进行两轮专家咨询，由专家对各指标重要性进行评分。采用百分权重法和乘积法计算各指标的权重，采用百分数法确定各指标筛选界值，以确定最终指标体系。结果两轮咨询的问卷有效回收率均为100.0%，咨询专家的权威程度分别为0.825、0.830，专家协调系数分别为0.253、0.286。最终确定的全科医师规范化培训考核指标体系包括一级指标7个，二级指标30个，三级指标95个。7个一级指标分别为人文技能考核、临床文书及诊断思维考核、临床基本技能考核、社区疾病考核、全科医师实践考核、医学专科技能考核、医疗继续教育考核，权重分别为0.040、0.019、0.419、0.268、0.114、0.131、0.009。结论本研究建立的全科医师规范化培训考核指标体系可信度较高，从7个维度规范了全科医师的考核标准，对于保障全科医师规范化培训质量具有重要意义。%Objective To establish appraisal index system of standardized training of general practitioners and unify the training assessment standards and ensure the quality of training. Methods From March 2014 to March 2015,30 experts in general practice field were selected from clinical base and community base of standardized training of general practitioners in Tianjin. According to Delphi's implementation procedures,two - round expert consultation was conducted by sending E - mails and the importance of each index was graded by experts. The weights of each index were calculated by the method of weighting and multiplication method. To finally make sure the index system,the percentage method was used to determine the selected cut - off value of each index. Results The effective response rate of questionnaires of the two - round consultation was 100. 0% ,the degrees of authority of consultant experts were 0. 825 and 0. 830 respectively,the coefficients of expert coordination were 0. 253 and 0. 286 respectively. Finally seven first - grade indexes and 30 second - grade indexes and 95 third - grade indexes of standardized training of general practitioners were determined. The seven first - grade indexes included the humanities skills assessment,clinical instruments and diagnostic thinking assessment, clinical basic skills assessment, community disease assessment,practice assessment of general practitioners,medical specialist skills assessment and continuing education of medical treatment assessment; and their respective weight coefficients were 0. 040,0. 019,0. 419,0. 268,0. 114,0. 131 and 0. 009. Conclusion The standardized index system of general practitioners established in the study has rather high reliability, and normalizes the criteria of assessment of general practitioners from seven dimensions,which is of great importance in protecting the quality of standardization training in general practitioners.