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.

PurposeStandardised 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 settingThis 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.ResultsThe 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).ConclusionsIn 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.

ContextThe 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).ObjectivesTo 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.MethodsAn 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.ResultsUnivariate 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, β = −0.24, 95% CI: −0.38~-0.11), professional meaning identity (PMI, β = −0.12, 95% CI: −0.23~0.03), and emotional exhaustion (EE, β = 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 (β = −0.24, 95% CI: −0.32~0.16).ConclusionPI 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.

ObjectivesChinese 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 settingThe 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.ResultsThe 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).ConclusionsThe 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.

ObjectiveTo 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.MethodsFrom 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.ResultsA 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 &lt; 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 &lt; 0.05).ConclusionThis 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.