Construction of an ethical competency evaluation system for clinical physicians in China

The improvement of the doctor-patient relationship is benefit for the clinic therapy. Thus improving doctors' ethical competence, and alleviating the extent of doctor-patient conflicts have become critical issues that need to be addressed. From an international perspective, owing to the development of ethical competency, there has been considerable progress in the management system of medical ethics. However, owing to cultural differences, China's ethical capabilities differ from those of the West. Research on medical ethics in China's medical field lacks systematic summarization. This study aimed to establish an evaluation system for Chinese doctors' ethical competency under the background of China's ethical environment, providing guidance and assistance for doctors to improve their ethical competency.

This study was conducted using a literature review, interviews, and the expert Delphi method. After interviewing 34 participants including 25 doctors, 3 ethics teachers, and 6 students, data analysis was conducted, and the initial version of the evaluation system was established. On this basis, by selecting 20 experts in the fields of medicine and ethics, amongst others, after two rounds of expert Delphi method questionnaire consultation, the indicators in the evaluation system were adjusted and modified; furthermore, the weight of each indicator was clarified to establish the evaluation system for doctors' ethical competency.

Based on the five elements of knowledge, motivation, attitude, quality, and skills as a framework, an evaluation system for doctors' ethical competency was established, including 12 primary and 39 secondary indicators. The primary indicators included personal ethical level, legal regulations, respect, benefit, fairness, privacy protection, physician beliefs, professional ethics, research ethics, decision-making skills, communication skills, and exploratory skills.

In this work, an ethical competency evaluation system for clinical physicians in China was constructed. This evaluation system can be developed into a questionnaire to measure the ethical competency of current Chinese clinical physicians, identify the strengths and weaknesses of their ethical competency, provide analysis from various perspectives, such as national policies and continued education, and explore paths to improve physicians' ethical competency, which can also give a useful reference for the education and training of medical students.