Index development and empirical research on the assessment of rural order-oriented general practice residents based on entrustable professional activities
10.3760/cma.j.cn114798-20250310-00195
- VernacularTitle:基于置信职业行为的农村订单定向全科住院医师评价指标体系构建与实证研究
- Author:
Yunhong ZHANG
1
;
Long LONG
1
;
Min SHA
1
;
Yanping ZHAO
1
;
Xuelian ZHANG
1
;
Huiyuan SHE
1
;
Bifang ZHANG
1
;
Dongyan YANG
1
;
Yu YANG
1
Author Information
1. 大理州人民医院全科医学科，大理 671000
- Publication Type:Journal Article
- Keywords:
General practice;
Residents;
Entrustable professional activities;
Rural order-oriented;
Delphi method;
Empirical research
- From:
Chinese Journal of General Practitioners
2025;24(11):1368-1377
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct an evaluation index system for rural order-oriented general practice residents based on Entrustable Professional Activities (EPAs) and conduct an empirical analysis. ?Methods:A mixed-methods study design was adopted (November 2022-April 2023). The preliminary draft of the index system was developed through literature review and group discussions, then refined and improved via two rounds of expert consultation using the Delphi method. The analytic hierarchy process (AHP) was applied to determine the weight of each index. Meanwhile, questionnaires were distributed to 181 participants, including general practitioners from general hospitals, general practitioners from community hospitals, and general practice residents. The scores of the three groups regarding the importance and feasibility of the indices were compared. Ten general practitioners of the above three types were selected for semi-structured interviews on their cognitive and practical aspects of the system. ?Results:The positive coefficients of the two rounds of expert consultation were 16/17 and 16/16, respectively. The expert authority degree was >0.70, and the test of coordination coefficient was statistically significant ( P<0.05). Finally, an index system consisting of 20 first-level indices and 56 second-level indices was established. In terms of weight, among the first-level indices,"EPA1: Information Acquisition"had the highest weight (0.11), while"EPA12: Clinical Research"had the lowest (0.02). Among the second-level indices, "Medical History Taking" and "Physical Examination" under EPA1 had the highest weight (both 0.056), while "Healthcare for Patients with Severe Mental Illness" and "Healthcare for Disabled and Handicapped Populations" under EPA15 had the lowest (both 0.003). The 181 participants gave scores ranging from 4.49 to 4.92 for the importance of the 20 first-level indices and from 4.16 to 4.81 for their feasibility. Only for" EPA19: Common Diseases in Primary Care and Health Management", the feasibility score given by general practitioners from community hospitals was higher than that from general hospitals ( t=2.157, P=0.032); no statistically significant differences were observed among the groups for the other indices ( P>0.05).The interview results showed that general practitioners have a relatively high level of recognition for this system, but there is still room for improvement in its practical application.? Conclusions:The evaluation index system for rural order-oriented general practice residents constructed based on EPAs has high reliability, and it is consistently recognized by different types of general practitioners. It can provide a reference for the cultivation of post competency of this group.?
