Construction of an Evaluation Indexes Framework of Primary Care Competencies for Chinese General Practitioners

Abstract

Abstract Background: The training of general practitioners (GPs) is important for the implementation of a tiered diagnosis and treatment system and realization of Healthy China 2030. A GPs training system in line with Chinese characteristics has been established, of which the standardized residency training program is the most important part. Primary care competencies (PCC) are essential for GPs, but there is a lack of research on the evaluation of PCC for Chinese GPs. Aim: The study was to construct a more suitable evaluation indexes framework (EIF) of PCC for Chinese GPs by using mixed methods research. Methods: The research included three steps: (1) Selecting five representative competency frameworks from literature for description, explanation and comparison, extracting evaluation indexes for EIF, and generating an evaluation indexes pool; (2) Using one-to-one in-depth structured interviews with 12 GPs to add new evaluation indexes and generate a preliminary EIF through coding of the interview content; (3) Optimizing the evaluation indexes and determining the EIF by Delphi method consultation with 25 general practice experts. Results: Five representative competency frameworks of GPs were compared, and sixty-five indexes were selected to establish the evaluation index pool. A preliminary EIF with 120 indexes were generated after in-depth interviews with 12 GPs. These indexeswere refined, leaving 108 indexes for the Delphi process with 25 general practice experts, which produced a final EIF of PCC for GPs including 8 level-1 indexes, 24 level-2 indexes and 76 level-3 indexes. Conclusion: An evaluation indexes framework of primary care competencies for GPs was established in this study, which had eight level-1 indexes including theoretical knowledge, physical examination, basic skills operation, auxiliary exam interpretation, clinical reasoning, medical documents writing, communication and health management. These represent the primary care competency needs for Chinese GPs.