基于关键事件的医生胜任力模型探索性研究：克拉玛依市某医院为例

Exploratory Study on Doctor Competency Model Based on Key Events: A Case Study of a Hospital in Karamay City

摘要: 本研究通过质性探究，从医生、非医疗工作人员及患者等多元视角出发，系统分析了医生职业所需的核心资质要求。作为一项系统性实证工作场所分析项目的重要组成部分，研究对涵盖不同专业领域及专科的74名对象进行了深度访谈，采用非结构化的行为事件访谈法，聚焦于医疗实践中的关键事件及相关行为，并参考了《德国国家基于胜任力的医学教育学习目标目录》作为分析框架。分析最终确定了11项与工作绩效密切相关的医生胜任力，并将其归纳为人际交往、工作相关和自我相关三大核心集群。研究发现，医生与非医疗工作人员的视角完整涵盖了全部胜任力，而患者视角则未能包含“团队合作”、“压力应对”和“批评应对”这三项，揭示了医疗从业者与患者在认知上存在的“盲区”。访谈中提取的大部分关键行为能与NKLM框架对应，但该框架也包含了一些访谈未涉及的内容。总体而言，基于行为事件构建的医生胜任力框架在结构上与其他职业的成熟模型相似。本研究所获得的具体行为描述结果，可直接应用于医学生选拔、医护人员职业发展项目的练习设计，并为制定针对不同医学专科的潜力评估工具提供依据。后续研究计划通过大样本定量方法对这些发现进行验证与拓展，其长期目标在于系统界定医学关键胜任力，以优化人才选拔与发展体系，并为专科评估提供科学基础。

Abstract: This study, through qualitative exploration, systematically analyzed the core competency requirements for the doctor profession from multiple perspectives, including doctors, non-medical staff, and patients. As an important component of a systematic empirical workplace analysis project, the study conducted in-depth interviews with 74 subjects covering different professional fields and specialties, using unstructured behavioral event interviewing to focus on key events and related behaviors in medical practice. The study also referenced the “German National Competency-Based Medical Education Learning Objectives Catalogue” as an analytical framework. The analysis ultimately identified 11 doctor competencies closely related to job performance, which were categorized into three core clusters: interpersonal communication, job-related, and self-related. The study found that the perspectives of doctors and non-medical staff fully covered all competencies, while the patient perspective did not include “teamwork,” “stress management,” and “criticism handling,” revealing cognitive “blind spots” between medical practitioners and patients. Most of the key behaviors extracted from the interviews could be mapped to the NKLM framework, but the framework also included some content not covered in the interviews. Overall, the doctor competency framework constructed based on behavioral events is structurally similar to mature models for other professions. The specific behavioral descriptions obtained in this study can be directly applied to the selection of medical students and the design of practice projects for healthcare professionals’ career development programs, and provide a basis for developing potential assessment tools tailored to different medical specialties. Subsequent research plans to validate and expand these findings through large-sample quantitative methods, with the long-term goal of systematically defining key medical competencies to optimize talent selection and development systems, and provide a scientific foundation for specialty assessments.