背景：高等院校附属医院承担医科教学以及科学研究的重要任务，不仅是医学教育的主力军，也是促进科研高质量发展的重要阵地，更加需要重视高质量科研人才的培养需求。本研究引入科研胜任力理念，探索高校附属医院青年医师的科研胜任力指标体系，为该群体的人才评估和培养发展给予一定的评价支持。目的：(1)以胜任力模型为理论基础，使用德尔菲法确立高校附属医院医师科研胜任力评价指标体系。(2)利用层次分析法确立科研胜任力评价指标体系权重。(3)在清华大学附属医院内进行小样本调查以验证科研胜任力自评量表的可行性。 方法：采用文献研究、专家会议法对高校附属医院青年医师科研胜任力进行定义并提取初始指标；采用德尔菲法合并层次分析法对指标进行筛选与权重确定；采用简单随机抽样法，在清华大学附属医院青年医师内进行调查，通过项目分析、信效度检验以及验证性因子分析对自评量表进行进一步探索与检验。结果：(1)研究共计17位专家参与德尔菲咨询，专家应答率为81.1%，两轮咨询的专家权威系数分别为0.88与0.82，专家协调系数分别为0.189与0.161(p＜0.001)，最终确立了包含个人特质与科研能力2个一级指标、8个二级指标与29条三级指标的高校附属医院青年医师科研胜任力指标体系。(2)通过层次分析法，各指标权重确立为：一级指标A个人特质权重为0.42，B科研能力权重为0.58。二级指标权重分配为A1-科研意愿(0.27)，A2-持续行动(0.40)，A3-沟通能力(0.17)，A4-领导能力(0.16)，B1-临床业务水平(0.24)，B2-科研技能(0.29)，B3-持续学习(0.29)，B4-科研筹资(0.18)。(3)小样本预调查(n=70)显示，量表整体Cronbach.α系数为0.968，折半系数为0.884。KMO值为0.886，巴特利特球形值p＜0.001。探索性因子共提取8个公因子，旋转后累积方差解释率为84.437%，指标所属因子与预设维度基本一致。验证性因子分析结果显示，量表各指标因子载荷系数＞0.7，相关性良好；各维度AVE值＞0.5且CR值＞0.7，区分效度良好；AVE平方根值均高于因子间相关系数的最大绝对值，聚合效度良好。此外，由于调查样本不足量表指标的5-10倍，暂不进行模型拟合与调整。 结论：本研究结合定量与定性的研究方法，初步对高校附属医院青年医师科研胜任力评价指标体系进行了探索。量表探索结果同预设结构一致，且可行性与信效度良好，在青年医师的人才培养与评价支持上具备一定的参考价值。
Background: The University affiliated Hospitals undertake the important tasks of medical teaching as well as scientific research, which is not only the main force of medical education, but also an important position to promote the development of high-quality scientific research, so it is more important to pay attention to the cultivation of high-quality scientific research talents. This project introduces the concept of scientific research competence and explores the index system of scientific research competence of young physicians in hospitals affiliated to universities, so as to provide certain evaluation support for the talent assessment and training development of this group.Objectives: (1) Take the competency model as the theoretical basis and use the Delphi method to establish the evaluation index system of scientific research competency of physicians in university-affiliated hospitals. (2) Use hierarchical analysis to establish the weights of scientific research competency evaluation index system. (3) Conduct a small sample survey within Tsinghua University Hospital to verify the feasibility of the self-assessment scale of scientific research competence. Methods: Literature research and expert meeting method were used to define the scientific research competence of young physicians in university-affiliated hospitals and to extract the initial indicators; Delphi method and combined hierarchical analysis method were used to screen the indicators and determine the weights; simple random sampling method was used to conduct a survey within young physicians in Tsinghua University hospitals, and the indicators were further screened through validation factor analysis, item analysis and feasibility analysis and reliability test for scale evaluation. The scale was evaluated by feasibility analysis and reliability test.Results: (1) A total of 17 experts participated in the Delphi consultation, the response rate of the first consultation was 81.1%, 100% in the second part. The expert authority coefficients of the two rounds of consultation were 0.88 and 0.82, and the coordination coefficients of the experts were 0.189 and 0.161 (p＜0.001), respectively. The index system of scientific research competence of young physician was established, which included 2 primary indicators of personal characteristics and scientific research competence, 8 secondary indicators, and 29 indicators of tertiary indicators. The index system of scientific research competence of young physicians in university-affiliated hospitals. (2) Through the hierarchical analysis method, the weight of personal traits in the first-level index was 0.42, and the weight of scientific research ability was 0.58. The weights of the second-level indexes were assigned as A1-scientific research willingness (0.27), A2-sustained action (0.40), A3-communication ability (0.17), A4-leadership ability (0.16), B1-clinical operational level (0.24), B2-scientific research skills (0.29), B3-Continuous learning (0.29), B4-Research funding (0.18). (3) The result of pre-survey (n=70) showed that, the Cronbach.α=0.966, KMO=0.886, and the Bartlett sphericity value of p<0.001. Eight co-factors were extracted by the exploratory factors analysis (EFA), and the cumulative variance explained rate was 84.437%. The factors to which the indicators belonged were basically consistent with the preset dimensions. The results of confirmatory factor analysis (CFA) showed that, the factor loading coefficients of each indicator were all >0.7, which indicates good correlation; the AVE value of each dimension was >0.5 and the CR value was >0.7, indicating the good discriminant validity; of the scale; the square root values of the AVE were higher than the maximum absolute value of correlation coefficients between the factors, with good convergent validity. The results of the CFA showed good discriminant validity and convergent validity for the dimensions of the scale. In addition, the model fitting, and adjustment are not carried out due to the insufficient sample. Conclusion: This study combines quantitative and qualitative research methods, initially explores the evaluation index system of young physicians‘ scientific research competence in university-affiliated hospitals and constructs a self-assessment scale with a certain degree of differentiation, screening and universality. The feasibility and reliability of the scale are good, and it can provide evaluation support for corresponding talent training in the future, which has certain reference value.
