Abstract
BackgroundThe “5 + 3” residency training is the main stream general practitioner training program in China. However, a competency model is absent for evaluating the clinical competence attained by general practitioners after training. This study was conducted to develop a consensus set of competencies for general practitioners after standardized residency training in China.MethodsA modified Delphi process was deployed to develop the competency model, including two stages: (1) generation of an initial set of competencies derived from literature review, behavioral observation of GP–patient consultations, and critical incidents interview of GPs; (2) a 2-round, web-based Delphi survey of experts in general practice, selected using purposive sampling, to prioritize and gain consensus on the essential competencies of GPs.ResultsFrom literature review, behavioral observation, and critical incidents interview, 46 competencies in 7 domains were identified. After two rounds of Delphi survey of 28 participants (the mean age was 47.9 [9.3] years and 64.3% were women) representing a range of health professionals (GPs, managers, and researchers), a consensus was reached on 50 competencies categorized into 7 domains.ConclusionA consensus-based competency model for general practitioners in China has been identified which may be used to evaluate the general practitioners’ clinical competence after standardized training.
Highlights
The “5 + 3” residency training is the main stream general practitioner training program in China
21 experts were from Beijing, 2 experts were from Shanghai, and other 5 experts were from 5 provinces of China (Hainan, Zhejiang, Anhui, Hebei, Inner Mongolia)
One third of the participants were General practitioners (GPs) in Community health service institution (CHSI), 39.3% were GPs in hospital, 10.7% were researchers in primary care, and 17.9% were leaders of CHSI
Summary
The “5 + 3” residency training is the main stream general practitioner training program in China. This study was conducted to develop a consensus set of competencies for general practitioners after standardized residency training in China. Hospital-centric health delivery system was prevailing in China, in which patients preferred to get medical services in large public tertiary hospitals rather than PHC institutions, leading to a perception of health services as “too difficult to access and too expensive” [1]. With strong support of the government, primary care network was widely developed around China. According to the statistics in 2019, there were 954,390 PHC institutions across China, with 4.53 billion PHC visits (accounting for 52.0% of the total visits) [7], increased by 58.9% in comparison with the PHC visits in 2009 [8]
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