Identifying the competencies of doctors in China

Li Zhao, Tao Sun, Bao-Zhi Sun, Yu-Hong Zhao, John Norcini, Lincoln Chen

China adopted a Flexnerian model as its medical institutions developed over the recent past but the political, social, and economic environment has changed significantly since then. This has generated the need for educational reform, which in other countries, has largely been driven by competencies-oriented models such as those developed in Canada, and the United States. Our study sought to establish the competencies model, relevant to China, which will support educational reform efforts. Data was collected using a cross-sectional survey of 1776 doctors from seven provinces in China. The surveys were translated and adapted from the Occupational Information Network General Work Activity questionnaire (O*NET-GWA) and Work Style questionnaire (O*NET-WS) developed under the auspices of the US Department of Labor. Exploratory factor analysis and confirmatory factor analysis ascertained the latent dimensions of the questionnaires, as well as the factor structures of the competencies model for the Chinese doctors. In exploratory factor analysis, the questionnaires were able to account for 64.25 % of total variance. All responses had high internal consistency and reliability. In confirmatory factor analysis, the loadings of six constructs were between 0.53 ~ 0.89 and were significant, Construct reliability (CR) were between 0.79 ~ 0.93 respectively. The results showed good convergent validity. The resultant models fit the data well (GFI was 0.92, RMSEA was 0.07) and the six-factor competencies framework for Chinese doctors emerged. The Chinese doctors' competencies framework includes six elements: (a) technical procedural skills; (b) diagnosis and management; (c) teamwork and administration; (d) communication; (e) professional behavior; and (f) professional values. These findings are relevant to China, consistent with its current situation, and similar to those developed in other countries.