Development of an index system for the scientific literacy of medical staff: a modified Delphi study in China.

BACKGROUND: Scientific research activity in hospitals is important for promoting the development of clinical medicine, and the scientific literacy of medical staff plays an important role in improving the quality and competitiveness of hospital research. To date, no index system applicable to the scientific literacy of medical staff in China has been developed that can effectively evaluate and guide scientific literacy. This study aimed to establish an index system for the scientific literacy of medical staff in China and provide a reference for improving the evaluation of this system. METHODS: In this study, a preliminary indicator pool for the scientific literacy of medical staff was constructed through the nominal group technique (n = 16) with medical staff. Then, two rounds of Delphi expert consultation surveys (n = 20) were conducted with clinicians, and the indicators were screened, revised and supplemented using the boundary value method and expert opinions. Next, the hierarchical analysis method was utilized to determine the weights of the indicators and ultimately establish a scientific literacy indicator system for medical staff. RESULTS: Following expert opinion, the index system for the scientific literacy of medical staff featuring 2 first-level indicators, 9 second-level indicators, and 38 third-level indicators was ultimately established, and the weights of the indicators were calculated. The two first-level indicators were research literacy and research ability, and the second-level indicators were research attitude (0.375), ability to identify problems (0.2038), basic literacy (0.1250), ability to implement projects (0.0843), research output capacity (0.0747), professional capacity (0.0735), data-processing capacity (0.0239), thesis-writing skills (0.0217), and ability to use literature (0.0181). CONCLUSIONS: This study constructed a comprehensive scientific literacy index system that can assess medical staff's scientific literacy and serve as a reference for evaluating and improving their scientific literacy.

The development and validation of the hospital organizational environment scale for medical staff in China.

Objectives: There is currently no measure of the hospital organizational environment targeting both clinicians and nurses in China. This study was conducted with the aim of developing and testing an instrument to assess the properties of the hospital organizational environment that is applicable to Chinese medical staff. Methods: Items were developed based on a literature review, semi-structured interviews and an expert review and finalized based on corrected item-total correlation, content validity, construct validity, convergent validity, discriminant validity and reliability. The two samples for testing the first and final version of the Hospital Organizational Environment Scale (HOES) included 447 and 424 participants, respectively. Results: The primary test, which comprised 18 items, contained four factors: hospital culture, work situation, organizational support and scientific research situation. The Cronbach's alphas were 0.935, 0.824, 0.943, and 0.920, respectively. The results of the validation test showed that the questionnaire had good validity and reliability. Conclusion: The HOES is a comprehensive instrument with demonstrated validity and reliability that can be adopted among medical staff to assess the organizational environment in hospitals.

What factors affect Beijing residents' contracts with family doctors? A comparative study of Beijing's urban and suburban areas.

Objective: To improve the health of residents and promote hierarchical diagnosis and treatment to achieve an orderly pattern of medical treatment, Beijing implemented family doctor contract services (FDCSs) in 2011. The aims of this study were to analyze the current status of Beijing residents' contracts with family doctors (FDs), compare the differences in contracting between urban and suburban residents, and explore the factors that affect residents' contract behavior. Methods: From August 2020 to October 2020, a stratified sampling method was adopted to select residents from community health centers (CHCs) in districts D (urban area) and S (suburb) of Beijing to conduct a questionnaire survey. Chi-square tests, rank sum tests and logistic regression analyzes were used to analyze the current status and influencing factors of residents' contracting with FDs. Results: A total of 4,113 valid questionnaires were included in the final analysis. District D was rich in medical resources, and the FD contract rate of residents there (93.09%) was significantly higher than that of residents in district S (78.06%; p < 0.05). Residents' district (OR = 1.55, 95% CI = 1.18-2.05), understanding of FDCS policies (OR = 4.13, 95% CI = 3.63-4.69), preferred medical institutions (OR = 0.58, 95% CI = 0.42-0.79 for tertiary hospitals in the district; OR = 0.36, 95% CI = 0.22-0.59 for urban medical institutions in Beijing), age, education level, average annual medical expenses and medical insurance type were factors that influenced residents' contracts with FDs (p < 0.05). Conclusion: This study shows that residents who are located in districts with rich medical resources, prefer CHCs as their first choice, have a better understanding of FDCS policies, and are more inclined to contract with FDs than other residents. It is recommended that the number and quality of FDs in suburban areas be increased and that medical staff strengthen publicity about FDCSs and actively encourage residents to contract with FDs.

Identifying strategic human resource management ability in the clinical departments of public hospitals in China: a modified Delphi study.

OBJECTIVES: Chinese public hospitals are managed like a bureaucracy, which is divided into two levels of hospital and departmental management. Improving strategic human resource management ability (SHRMA) within clinical departments can improve department performance and service quality, which is an important way for public hospitals to obtain an advantage in a diversified competitive medical market. However, there is a lack of specialised evaluation tools for SHRMA in clinical departments to support this effort. Therefore, this study aims to develop an index for evaluating the SHRMA of clinical departments in public hospitals. STUDY DESIGN AND SETTING: The Delphi technique was carried out with 22 experts, and an evaluation index of the SHRMA in the clinical departments of public hospitals was constructed. The weight of each indicator was calculated by the intuitive fuzzy analytic hierarchy process. RESULTS: The SHRMA index constructed in this study for the clinical departments in public hospitals includes 5 first-level indicators, 13 second-level indicators and 36 third-level indicators. The first-level indicators are distributed in weight among human resource maintenance (0.204), human resource planning (0.201), human resource development (0.200), human resource stimulation (0.198) and human resource absorption (0.198). The top three weighted indicators on the second level are job analysis and position evaluation (0.105), career management (0.103) and salary incentivisation (0.100). CONCLUSIONS: The index constructed in this study is scientific and feasible and is expected to provide an effective tool for the quantitative evaluation of SHRMA in the clinical departments of public hospitals in China.

How to become an excellent pediatric resident: a qualitative comparative study from China.

BACKGROUND: Competency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of excellent pediatric residents and general pediatric residents and to provide a scientific reference for the talent training and career development of pediatric residents. METHODS: Behavioral event interviews were conducted with 23 pediatric residents at a children's hospital in Beijing in July and August 2019. Two researchers coded the interview data to summarize the competency of pediatric residents. The research group scored the performance of 23 pediatric residents in various aspects of competency and used the crisp-set qualitative comparative analysis method to explore the competency configurations of excellent pediatric residents and general pediatric residents. RESULTS: This study concludes that pediatric residents should have six core competencies: professional spirit, clinical skills, communication ability, learning ability, mental capacity and research ability. There are 4 combinations of competencies for becoming an excellent pediatric resident: the clinical type, scientific research type, all-around development type and high emotional intelligence type. In addition, there are 3 combinations of competencies for becoming a general pediatric resident: the comprehensive ability deficiency type, lack of professionalism and mental capacity type, lack of communication ability type. CONCLUSIONS: There are differences in competence between excellent and general pediatric residents. Excellent pediatric residents do not need to possess all competencies but should specialize in clinical practice, scientific research or communication skills. This study suggests that training in mental capacity, professional spirit and communication ability should be strengthened during pediatric resident training. Pediatric residents should make career development plans according to their actual situation, and hospitals should arrange suitable positions according to the characteristics of pediatric residents.

Associations between professional identity and turnover intent in prehospital emergency physicians: The mediating effect of burnout.

Context: The prehospital emergency system is essential for reducing mortality and disability in emergency patients. However, the high turnover rate of prehospital emergency physicians (PEPs) remains the most prominent problems in the prehospital emergency system. Turnover intent (TI) is predictive of actual turnover behavior; however, previous studies have mainly focused on sociodemographic factors and job characteristics, ignoring many other potential psychological factors, such as professional identity (PI) and job burnout (JB). Objectives: To measure the level of PI, JB, and TI of PEPs in Beijing, China. We analyze the distribution of TI in different social demography PEPs and then further explore the influence of PI and JB on TI, to provide a reference and suggestions for government departments to reduce the TI of PEPs. Methods: An online questionnaire was distributed to 552 PEPs in Beijing, and a total of 533 valid questionnaires were included. T-test and variance analysis were used to examine the differences in the distribution of TI among different sociodemographic PEPs. Pearson's correlation analysis was used to test the correlation between PI, JB, and TI. The SEM was used to analyze the relationships among PI, JB, and TI. Results: Univariate analysis showed that age, marital status, education, professional title, work experience, department and hukou were significantly associated with TI. Pearson's correlation analysis showed that PI was negatively associated with JB and TI, and JB was positively associated with TI. Professional treatment identity (PTI, ß = -0.24, 95% CI: -0.38~-0.11), professional meaning identity (PMI, ß = -0.12, 95% CI: -0.23~0.03), and emotional exhaustion (EE, ß = 0.40, 95% CI: 0.28~0.51) seem to have direct impacts on TI. Given the mediating role played by EE, PTI may have an indirect negative effect on TI (ß = -0.24, 95% CI: -0.32~0.16). Conclusion: PI and JB of PEPs in China are closely related to TI, which may have unexpected effects on government departments to stabilize the team of PEPs through a series of control measures. According to the above results, the professional treatment of PEPs needs to be improved, and external learning opportunities should be increased. Legalization of medical rescue workers should also be on the agenda.

Identifying the competencies of China's paediatric residents: a modified Delphi method study.

PURPOSE: Standardised Training of Paediatric Resident (STPR) plays an essential role in training qualified paediatricians. Until now, China had no paediatric resident competency index system to effectively guide and evaluate the competence of paediatric residents. This study aimed to establish a competency index system for paediatric residents in China to provide a reference for improving the training system and quality of STPR. STUDY DESIGN AND SETTING: This study conducted two rounds of Delphi expert consultation survey among paediatric medical experts (n=16), followed by screening, revising and supplementing indicators using the boundary value method. Next, the analytic hierarchy process was used to determine the weight of indicators and finally establish a competency index system for paediatric residents. RESULTS: The results of the statistical analysis revealed a positive coefficient of 100% for both rounds of expert consultation. The expert authority coefficient values were 0.82 and 0.83, and the expert coordination coefficient test was p<0.01. After referring to experts' opinions, a competency index system for paediatric residents with 5 primary indicators, 14 secondary indicators and 73 tertiary indicators was finally formed and the weight of each indicator was calculated. The five primary indicators were professional quality (0.3187), knowledge and skills (0.2734), communication and cooperation (0.1986), lifelong learning (0.1302), and teaching ability (0.0791). CONCLUSIONS: In this study, a competency index system for paediatric residents was constructed following the characteristics and quality requirements for paediatric residents in China and is expected to significantly improve the overall level of paediatricians' medical service quality and supply.