健康发展与政策研究2026，Vol.29Issue(3)：432-438,470,8.DOI:10.12458/HDPR.202508047
基于洋葱模型的基层医疗卫生机构家庭医生团队长岗位素质评价指标体系构建和验证
Development and validation of an Onion Model-based competency evaluation index system for family doctor team leaders in primary healthcare institutions
摘要
Abstract
Objective This study attempts to develop an Onion Model-based competency evaluation index system for family doctor team leaders in primary healthcare institutions based on the onion model,so as to provide a basis for the selection,training,and evaluation of family doctor team leaders.Methods A preliminary item pool was generated through literature review,semi-structured interviews,and focus group discussions.A questionnaire survey was conducted among managers,family doctor team leaders,and team members at community health centers in Nanjing.Cronbach's α,exploratory factor analysis,and confirmatory factor analysis and were used to assess the reliability and validity of the index system.Structural equation modeling(SEM)was applied to validate relationships among competency factors.Results A preliminary item pool comprising 5 dimensions and 32 items was constructed.A total of 842 participants were surveyed.Exploratory factor analysis(n=300)extracted 5 common factors with a cumulative variance contribution rate of 90.563%.After deleting 4 items with cross-loadings,a final index system comprising 5 dimensions and 28 items were established:6 items for personality traits,4 items for values,8 items for role and attitude,6 items for implicit knowledge and skills,and 4 items for explicit knowledge and skills.Confirmatory factor analysis(n=542)showed good model fit(χ²/df=3.892,root mean square error of approximation=0.067,comparative fit index=0.928,Tucker-Lewis index=0.914).Reliability analysis of questionnaire data yielded a Cronbach's α of 0.994 and a split-half coefficient of 0.972,both above 0.9,demonstrating good reliability of scale items.Structural equation modeling revealed path coefficients ranging from 1.026 to 1.134 among all dimensions(P＜0.001).Conclusion The evaluation system,developed based on the Onion Model framework,demonstrates good reliability and validity,and can be used as an assessment tool for evaluating the job competency of family doctor team leaders in primary healthcare institutions.关键词
家庭医生团队长/核心素养/洋葱模型/量表/评价指标/信度Key words
family doctor team leader/core competencies/Onion Model/scale/evaluation indicators/reliability分类
医药卫生引用本文复制引用
宋希,章雨帆,赵宁,密一恺,王积慧,赵双烨,申玉英..基于洋葱模型的基层医疗卫生机构家庭医生团队长岗位素质评价指标体系构建和验证[J].健康发展与政策研究,2026,29(3):432-438,470,8.基金项目
江苏省医院协会2023年度医院管理创新研究课题(JSYGY-3-2023-264) （JSYGY-3-2023-264）
