A Competency Model for Clinical Physicians in China: A Cross-Sectional Survey

<div><p>Background</p><p>Around the world, regulatory bodies have taken the lead in determining the competencies required to become a physician. As a first step in addressing this project, it was decided to develop a set of core competencies that were unique to China and that might serve as a basis for medical education. The purpose of this paper was to construct a competency model for clinical physicians in China.</p><p>Methods</p><p>Data was collected using a cross-sectional survey of 6247 clinicians from seven administrative regions (31 provinces, autonomous regions and municipalities directly under the central government) in China. The total sample was randomly divided into two sub-samples, an initial sample (Sample 1) and a replication sample (Sample 2). Independent exploratory factor analysis was conducted in each sample and the results were compared to determine the stability. After that the confirmatory factor analysis was used to ascertain the competency model for physicians. The reliability, convergent and discriminant validity of competency-based instrument were also examined.</p><p>Results</p><p>76 items with 8 dimensions were identified, accounting for 68.41% of the construct’s total variance in the initial sample and 67.47% in the replication sample. For the two samples, the overall scale reliability (Cronbach’s alpha) was both 0.985 with dimensions from 0.905 to 0.954 for the initial sample and from 0.902 to 0.955 for the replication sample after deleting the items. In confirmatory factor analysis, the result showed that all items had acceptable goodness of fit index. RMSEA and SRMR were less than 0.08 (RMSEA = 0.046, SRMR = 0.040), while GFI, NFI, IFI, and CFI were higher than 0.9 (GFI = 0.905, NFI = 0.903, IFI = 0.909, CFI = 0.909), leading to acceptable construct validity. All construct reliability values of the factors were higher than 0.70, and all average variance extracted values exceeded 0.50. Thus, we considered the reliability and validity of the 8 dimensions were acceptable.</p><p>Conclusions</p><p>The instrument was shown to be both valid and reliable for measuring clinical physicians’ competency in China. The results of the competency-based instrument can be used by ministry of health and administrators of hospitals to assess physicians’ competencies, encourage and guide them to modify their behaviors according to the evaluation criteria, and also cultivate physicians with strong clinical practice, innovation and independent scientific research ability. Through these measurements and understandings, the overall level of clinical physicians will be increased in China.</p></div

The cumulative variance and Cronbach’s alpha in two samples after deleting items.

<p>The cumulative variance and Cronbach’s alpha in two samples after deleting items.</p

Demographic characteristics.

<p>Demographic characteristics.</p

Comparisons of competencies frameworks.

<p>Comparisons of competencies frameworks.</p

The factor loadings after promax rotation in Sample 1.

<p>The factor loadings after promax rotation in Sample 1.</p

The factor loadings after promax rotation in Sample 2.

<p>The factor loadings after promax rotation in Sample 2.</p

Additional file 1: of Handgrip strength is positively related to blood pressure and hypertension risk: results from the National Health and nutrition examination survey

Table S1. Association between handgrip strength and SBP adjusted for age and BMI stratified by gender. Table S2. Association between handgrip strength and DBP stratified by gender. (DOCX 15 kb

Additional file 1: of Application of latent class analysis in assessing the competency of physicians in China

Chinese physician’s competency questionnaire. (DOCX 29 kb

An Aptamer-Based Biosensor for Colorimetric Detection of <em>Escherichia coli</em> O157:H7

<div><h3>Background</h3><p>An aptamer based biosensor (aptasensor) was developed and evaluated for rapid colorimetric detection of <em>Escherichia coli</em> (<em>E</em>. <em>coli</em>) O157:H7.</p> <h3>Methodology/Principal Findings</h3><p>The aptasensor was assembled by modifying the truncated lipopolysaccharides (LPS)-binding aptamer on the surface of nanoscale polydiacetylene (PDA) vesicle using peptide bonding between the carboxyl group of the vesicle and the amine group of the aptamer. Molecular recognition between <em>E. coli</em> O157:H7 and aptamer at the interface of the vesicle lead to blue-red transition of PDA which was readily visible to the naked eyes and could be quantified by colorimetric responses (CR). Confocal laser scanning microscope (CLSM) and transmission electron microscopy (TEM) was used to confirm the specific interactions between the truncated aptamer and <em>E</em>. <em>coli</em> O157:H7. The aptasensor could detect cellular concentrations in a range of 10⁴∼ 10⁸ colony-forming units (CFU)/ml within 2 hours and its specificity was 100% for detection of <em>E. coli</em> O157:H7. Compared with the standard culture method, the correspondent rate was 98.5% for the detection of <em>E</em>. <em>coli</em> O157:H7 on 203 clinical fecal specimens with our aptasensor.</p> <h3>Conclusions</h3><p>The new aptasensor represents a significant advancement in detection capabilities based on the combination of nucleic acid aptamer with PDA vesicle, and offers a specific and convenient screening method for the detection of pathogenic bacteria. This technic could also be applied in areas from clinical analysis to biological terrorism defense, especially in low-resource settings.</p> </div

Performance comparison between biosensors for the Detection of <i>E. coli</i> O157:H7.

<p>Performance comparison between biosensors for the Detection of <i>E. coli</i> O157:H7.</p