Identifying the competencies of doctors in China

Area of Science:

• Medical Education
• Health Workforce Development
• Competency-Based Education

Background:

• China's medical education system, initially based on a Flexnerian model, requires reform due to significant political, social, and economic changes.
• International models, particularly competency-oriented ones from Canada and the US, offer frameworks for educational reform.

Purpose of the Study:

• To establish a relevant competencies model for Chinese doctors to support educational reform efforts.
• To adapt and validate international competency assessment tools for the Chinese context.

Main Methods:

• A cross-sectional survey was administered to 1776 doctors across seven Chinese provinces.
• Validated questionnaires, adapted from the US Department of Labor's O*NET-GWA and O*NET-WS, were used.
• Exploratory and confirmatory factor analyses were employed to determine the model's structure.

Main Results:

• Exploratory factor analysis explained 64.25% of the total variance with high internal consistency and reliability.
• Confirmatory factor analysis confirmed a six-factor model with significant loadings (0.53–0.89) and good construct reliability (0.79–0.93).
• The model demonstrated good convergent validity and fit the data well (GFI=0.92, RMSEA=0.07).

Conclusions:

• A six-element competencies framework for Chinese doctors was identified: technical skills, diagnosis/management, teamwork/administration, communication, professional behavior, and professional values.
• The developed framework is relevant to China's current situation and aligns with international competency models.
• This framework provides a foundation for evidence-based medical education reform in China.