基于人才培养的上海市某区全科医生综合能力评价研究

背景　我国全科人才队伍建设相对滞后，合格的全科医生输入严重不足，制约了基层医疗卫生服务水平。目前国内外对全科医生的能力评价主要依据世界家庭医师组织提出的6项核心胜任力，我国对全科医生能力评价研究较晚，研究多侧重从社区卫生服务中心主任、社区卫生服务中心机构、全科医生的临床能力等出发，对全科医生个人综合能力评价的相关研究较为缺乏。目的　建立全科医生综合能力评价体系，评价上海市某区全科医生的综合能力，从而指导全科医生实践，为建立全科人才队伍、培养优秀全科人才起到指导作用。方法　运用层次结构分析法建立全科医生综合能力评价体系，于2018年6月在上海市某区12家社区卫生服务中心中随机选取4名全科医生，共48名作为调查对象，通过问卷自评的形式对上海市某区全科医生综合能力进行评价。结果　研究从临床诊疗能力、公共卫生服务能力、科研能力、人文素养4个方面构建了全科医生综合能力评价体系。并对上海市某区全科医生进行评价，结果显示上海市某区全科医生评价的总平均得分为78.45分，该区全科医生综合能力属于中等偏上水平。人文素养得分最高，科教能力得分最低，临床诊疗能力和公共卫生服务能力位居中间。其中科教能力评分较低，仅为54.49分。结论　全科医生的培养必须多角度进行，在医疗、公共卫生、人文、科研方面，特别针对科研和教学等薄弱点，要提高认识、加大投入力度，提升全科医生综合能力。

Personal Development-oriented Comprehensive Ability Evaluation for General Practitioners: a Survey from a District of Shanghai

Background　The construction of general practitioner（GP） workforce in China is relatively backward.And insufficient qualified GPs introduced in primary care restricts the increase of primary care quality level. At present，the evaluation of the ability of GPs is mainly based on the six core competencies proposed by WONCA. In China，the research on the evaluation of GPs' ability started relatively late，which mainly focuses on the director of community health center（CHC），community healthcare institutions，clinical ability of GPs，but rarely involves personal comprehensive ability of GPs. Objective　To develop a comprehensive ability evaluation system for GPs and test its effectiveness in GPs from a district of Shanghai，providing guidance for the practice of GPs，development of GP workforce and cultivation of outstanding GPs. Methods　Analytic Hierarchy Process（AHP） was used to develop a questionnaire named as Comprehensive Ability Evaluation System for GPs.Then the questionnaire was used in a self-administered survey among 48 GPs from 12 CHCs（4 GPs from each） in a district of Shanghai in June 2018 for evaluating their comprehensive abilities. Results　 The system measures GPs' comprehensive abilities from four aspects：clinical diagnosis and therapeutic ability，public health service ability，research and teaching ability and humanistic literacy. The survey results showed that the mean overall score of comprehensive abilities for these GPs was 78.25 points，namely，an upper-middle level. Specifically，GPs scored highest in healthy literacy，followed by clinical diagnosis and therapeutic ability，public health service ability，and research and teaching ability. In particular，GPs scored only 54.49 points in scientific and research ability on average，which was the lowest among all item scores. Conclusion　The training of GPs must be carried out from multiple perspectives. To improve GPs' comprehensive abilities，inputs on medical，public health，health literacy and scientific and research trainings for them should be increased，with a focus on their weaknesses such as scientific research and teaching.