我国呼吸专科医师能力评价指标体系构建
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摘要
目的:构建国内呼吸专科医师能力评价指标体系。方法:通过文献研究、专家半结构式访谈,构建国内呼吸专科医师能力评价初步框架;运用改进型德尔菲法对13位呼吸专科医师进行开放式问卷调查,并对25位专家进行了两轮正式函询,请专家对指标重要性评分,对指标进一步优化,建立呼吸专科医师能力评价指标体系。结果:本研究所选25位专家主要来自国内呼吸与危重症学、医院管理和医学教育领域,平均专业年限为22.96年,两轮正式函询的专家权威系数为0.81,专家协调系数Kendall W的范围为0.14～0.23,P值均小于0.05。最终构建的一级指标为医学知识、患者诊疗、科研教学、职业素养、沟通合作、终身学习6个指标,下设55个二级指标。结论:本研究发现函询专家对科研教学能力要求意见不一致,部分专家对控烟工作的认知和重视程度明显不足。同时,该指标体系侧重理论层面,需进一步实化评价内容,以期形成行业共识。科学有效的评价指标体系将丰富呼吸专科医师规范化培训标准的内涵与外延,对呼吸与危重症医学专培质量的提升有重大实践意义。
Objectives:To establish an indicator system for the Pulmonary and Critical Care Medicine(PCCM) specialists' competency.Methods:Literature review and semi-structured expert interview were used to establish the preliminary framework of competency evaluation.Applying the modified Delphi method,we conducted unstructured interviews with 13 PCCM Specialists and inquired 25 experts via two-round letters.The experts weighed the metric of each indicator,and based on their suggestions we adjusted and optimized the indicators,thereby establishing the evaluation indicator system.Results:This study selected 25 experts in the fields of Pulmonary and Critical Care Medicine,Hospital Management and Medical Education,with22.96 years' professional experiences on average.After two rounds of inquiry,the expert's authority coefficient is 0.81,and the range of Kendall W is 0.14-0.23,meantime,the P values are below 0.05.The final 6 first-level indicators are Medical Knowledge,Patient Care,Scholarship and Teaching,Professionalism,Communication and Teamwork,and Life-long Learning.And there are 55 second-level indicators.Conclusion Our research showed that experts held different requirements for scholarship and teaching among PCCM Specialists,and some of the experts did not pay enough attention to tobacco control.Besides,our evaluation system mainly focuses on theory,and should be further refined in practice with the hope of becoming a consensus within respiratory community.The scientific and effective evaluation system would help to enrich the standard of PCCM fellowship training and improve its quality in China.
Objectives:To establish an indicator system for the Pulmonary and Critical Care Medicine(PCCM) specialists' competency.Methods:Literature review and semi-structured expert interview were used to establish the preliminary framework of competency evaluation.Applying the modified Delphi method,we conducted unstructured interviews with 13 PCCM Specialists and inquired 25 experts via two-round letters.The experts weighed the metric of each indicator,and based on their suggestions we adjusted and optimized the indicators,thereby establishing the evaluation indicator system.Results:This study selected 25 experts in the fields of Pulmonary and Critical Care Medicine,Hospital Management and Medical Education,with22.96 years' professional experiences on average.After two rounds of inquiry,the expert's authority coefficient is 0.81,and the range of Kendall W is 0.14-0.23,meantime,the P values are below 0.05.The final 6 first-level indicators are Medical Knowledge,Patient Care,Scholarship and Teaching,Professionalism,Communication and Teamwork,and Life-long Learning.And there are 55 second-level indicators.Conclusion Our research showed that experts held different requirements for scholarship and teaching among PCCM Specialists,and some of the experts did not pay enough attention to tobacco control.Besides,our evaluation system mainly focuses on theory,and should be further refined in practice with the hope of becoming a consensus within respiratory community.The scientific and effective evaluation system would help to enrich the standard of PCCM fellowship training and improve its quality in China.
引文
[1]张鹏俊,薛明,缪之文,等.我国呼吸专科医师队伍发展现状调查[J].中华医院管理杂志,2018,34(7):567-570.
[2]王辰.三驾马车带动我国呼吸学科全面发展[EB/OL].(2018-06-22)[2019-01-11].http://www.huxijie.com/nd.jsp?id=61.
[3]解立新.记录2017呼吸危重症进展:专培专修与单修认识伴质疑共前行[J].中华医学信息导报,2017,32(24):10.
[4]Hall DA,Smith H,Heffernan E,et al.Recruiting and retaining participants in e-Delphi surveys for core outcome set development:Evaluating the COMiT’ID study[J].PLoSOne,2018,13(7):e0201378.
[5]Kristi J.Verbeke,competencies for a leadership role in educational development[D].Detroit,Michigan:Wayne State University,2014.
[6]曾光.现代流行病学方法与应用[M].北京:北京医科大学、中国协和医科大学联合出版社,1994.
[7]郭亚楠,张瑶,张馨予,等.我国医院技术效率指标体系系统分析与优化研究[J].中华医院管理杂志,2017,33(8):619-622.
[8]纪婷婷,张鹏俊,张群,等.国外医师能力评价研究概述[J].中华医院管理杂志,2018,34(3):256-260.
[9]赵玉沛.以人民为中心,一切为了患者,在百年协和倒计时1000天启动仪式上的讲话[EB/OL].(2018-12-21)[2019-01-11].http://www.pumch.cn/detail/20451.html.
[10]Wang C,Xu J,Yang L,et al.Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH]study):a national cross-sectional study[J].The Lancet,2018,391(10131):1706-1717.
[11]Siegel RL,Miller KD,Jemal A.Cancer statistics,2019[J].CA Cancer J Clin,2019,69(1):7-34.
[2]王辰.三驾马车带动我国呼吸学科全面发展[EB/OL].(2018-06-22)[2019-01-11].http://www.huxijie.com/nd.jsp?id=61.
[3]解立新.记录2017呼吸危重症进展:专培专修与单修认识伴质疑共前行[J].中华医学信息导报,2017,32(24):10.
[4]Hall DA,Smith H,Heffernan E,et al.Recruiting and retaining participants in e-Delphi surveys for core outcome set development:Evaluating the COMiT’ID study[J].PLoSOne,2018,13(7):e0201378.
[5]Kristi J.Verbeke,competencies for a leadership role in educational development[D].Detroit,Michigan:Wayne State University,2014.
[6]曾光.现代流行病学方法与应用[M].北京:北京医科大学、中国协和医科大学联合出版社,1994.
[7]郭亚楠,张瑶,张馨予,等.我国医院技术效率指标体系系统分析与优化研究[J].中华医院管理杂志,2017,33(8):619-622.
[8]纪婷婷,张鹏俊,张群,等.国外医师能力评价研究概述[J].中华医院管理杂志,2018,34(3):256-260.
[9]赵玉沛.以人民为中心,一切为了患者,在百年协和倒计时1000天启动仪式上的讲话[EB/OL].(2018-12-21)[2019-01-11].http://www.pumch.cn/detail/20451.html.
[10]Wang C,Xu J,Yang L,et al.Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH]study):a national cross-sectional study[J].The Lancet,2018,391(10131):1706-1717.
[11]Siegel RL,Miller KD,Jemal A.Cancer statistics,2019[J].CA Cancer J Clin,2019,69(1):7-34.