Competency and Risk-relativity

In this paper I discuss the view that the appropriate concept of competence is a decision-relative one: that a person may be competent to make one decision but not another. The argument that I present is that neither of the two competing theories supporting the decision-relative approach, internalism and externalism, can provide a coherent explanation of why a person's competence should be thought to be relative to a particular decision. On the one hand, internalism, which regards competence as exhaustively a matter of the person's understanding, fails to identify the specific skills or content that would warrant linking a specific decision with competence, and thus cannot provide an account of decision-relative that parallels task-relative. On the other hand, externalism, which regards competence as a matter of the person's understanding in relation to external elements such as risk, cannot adequately defend why a person's competence to make a decision should 'track' the level of probable harm that results from the decision.     

Structural Competency in the U.S. Healthcare Crisis: Putting Social and Policy Interventions Into Clinical Practice

This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine.     

胜任力研究及在医院高层管理者胜任力特质测评中运用

以人格特质研究为主体,融合功能研究与情境研究,提出一个基于管理素养与专业技能并重的双核心胜任力模型思路。研究将对科学评价医院高层管理者胜任力提供参考。     

国外急诊专科医师胜任力框架及其应用概述

目的 对国外急诊专科医师胜任力要求及其应用进行比较分析,为我国开展急诊专科医师胜任力研究提供参考。方法 以美国、欧洲、加拿大和澳大利亚为研究对象,运用文献研究法检索国外相关机构官方网站和外文数据库,收集和分析各国急诊专科医师胜任力相关文献。结果 经过检索,共获得相关资料和文献1 740余篇,初筛后纳入文献136篇,复筛后最终纳入文献24篇。结论 胜任力研究已逐渐成为各国开展急诊专科医师培养的基础和关键,研究对于规范我国急诊医师培养和考核具有较强的借鉴意义。     

Cultural Competency and Rural Disorder in PNG Health Promotion

ABSTRACT

Health workers in Papua New Guinea strongly emphasise their duty to provide services to the country’s rural majority. Trained to see rural communities as lacking modern discipline and order, they worry that rural people will resist, perhaps with violence, if health workers fail to ‘show respect for culture’. Examining cultural improvisation among nursing students on a rural experience practicum in the Eastern Highlands, I show how students and teachers tried to craft culturally respectful health education. However, when difficulties emerged, local people were described as unable or unwilling to harim tok (understand, heed or follow instructions). The capacity to follow instructions, cultivated through education and Christian faith, was cast as incompatible with Highlands culture. Rural health promotion activities, when they fail to foment major transformation, can help reproduce the ideological construction of the people of the hauslain (village, hamlet) as emotionally volatile and ungovernable.     

妇产科医师鉴别胜任特征研究

目的 获取绩效优秀妇产科医师区别于绩效普通妇产科医师的胜任特征。方法 在编制医师胜任特征词典的基础上,以10名绩优和10名绩平医师为研究对象,采用行为事件访谈法收集数据,对不同绩效组医师胜任特征的频次、平均等级分值和最高等级分值的差异采用Wilcoxon秩和检验进行分析。结果 鉴别胜任特征包括严谨细致、团队合作等18项特征。结论 鉴别胜任特征对妇产科医师人力资源规划、招聘、培训有一定参考价值。

     

我国胜任特征模型研究综述

胜任特征模型现已成为人力资源开发中的一项主流实践活动,是人力资源开发的理论研究与实践探索的全球性热点之一。文章简要回顾了我国胜任特征的研究现状;作为人力资源管理的主流实践活动,对近5年我国胜任特征模型的构建方法、主要研究成果和发展趋势在文中作一综述。     

基于能力素质模型的医院人才开发

当前医疗体制改革的形势下,医院必须打造核心竞争力,提供优质、满意的医疗服务,才能在竞争中立于不败之地,因此需要一大批绩效卓越的人才。能力素质模型是人才胜任工作、实现医院战略目标所需要的知识技能和素质,其在人才培养中的作用、建立模型的方法和应注意的问题需要深入探讨。     

Resting-State Functional Connectivity Patterns Predict Chinese Word Reading Competency

Resting-state functional connectivity (RSFC) offers a novel approach to reveal the temporal synchronization of functionally related brain regions. Recent studies have identified several RSFCs whose strength was associated with reading competence in alphabetic languages. In the present study, we examined the role of intrinsic functional relations for reading a non-alphabetic language – Chinese – by correlating RSFC maps of nine Chinese reading-related seed regions and reaction time in the single-character reading task. We found that Chinese reading efficiency was positively correlated with the connection between left inferior occipital gyrus and left superior parietal lobule, between right posterior fusiform gyrus and right superior parietal lobule, and between left inferior temporal gyrus and left inferior parietal lobule. These results could not be attributed to inter-individual differences arising from the peripheral processes of the reading task such as visual input detection and articulation. The observed RSFC-reading correlation relationships are discussed in the framework of Chinese character reading, including visuospatial analyses and semantic/phonological processes.     

我国口腔医师岗位胜任力自评研究

目的 通过分析我国“5+1”阶段口腔医师胜任力自评问卷,验证胜任力指标的科学性。方法 自行编制口腔医师胜任力自评问卷,对全国14所高校附属口腔医院的350名“5+1”阶段口腔医师开展问卷调查,分析问卷的信度和效度检验,根据问卷分数分成高低两组,并进行独立样本的t检验。结果 “5+1”阶段口腔医师胜任力自评问卷共由7个维度、50个条目组成, Cronbach’s α系数均在0.8以上;经探索性因子分析后得到7个因子,7个因子的累计方差贡献率达67.272％;高分组和低分组的差异有统计学意义。结论 “5+1”阶段口腔医师胜任力自评问卷具有良好的信度和效度,适用于我国“5+1”阶段口腔医师胜任力的评价。     

名医胜任特征模型的构建研究

目的 借鉴现代人力资源管理理论——胜任力及胜任力模型研究,探讨我国名医胜任特征,构建名医胜任特征模型。方法 在文献研究、问卷调查和专家访谈的基础上,编制“名医胜任特征辞典”;采用自设问卷对各项胜任特征指标的重要程度进行评价;利用因子分析法和层次分析法构建名医胜任力模型。结果 名医具有以下7个维度的胜任特征：业务水平、大家认可、信念操守、人文素养、知识经验、名声信誉、成就品质,每一维度胜任特征包含多项因素,各项胜任特征及其内在因素在名医胜任特征模型中所占的权重不等。结论 名医胜任特征模型能够综合衡量卓越医师的岗位胜任能力,并且具有较强的适用性与可复制性,同时还反映了新时期职业精神和理想信念对一位医生成长、成才、成功的重要性越来越突出。     

Host Density and Competency Determine the Effects of Host Diversity on Trematode Parasite Infection

Variation in host species composition can dramatically alter parasite transmission in natural communities. Whether diverse host communities dilute or amplify parasite transmission is thought to depend critically on species traits, particularly on how hosts affect each other’s densities, and their relative competency as hosts. Here we studied a community of potential hosts and/or decoys (i.e. non-competent hosts) for two trematode parasite species, Echinostoma trivolvis and Ribeiroia ondatrae, which commonly infect wildlife across North America. We manipulated the density of a focal host (green frog tadpoles, Rana clamitans), in concert with manipulating the diversity of alternative species, to simulate communities where alternative species either (1) replace the focal host species so that the total number of individuals remains constant (substitution) or (2) add to total host density (addition). For E. trivolvis, we found that total parasite transmission remained roughly equal (or perhaps decreased slightly) when alternative species replaced focal host individuals, but parasite transmission was higher when alternative species were added to a community without replacing focal host individuals. Given the alternative species were roughly equal in competency, these results are consistent with current theory. Remarkably, both total tadpole and per-capita tadpole infection intensity by E. trivolvis increased with increasing intraspecific host density. For R. ondatrae, alternative species did not function as effective decoys or hosts for parasite infective stages, and the diversity and density treatments did not produce clear changes in parasite transmission, although high tank to tank variation in R. ondatrae infection could have obscured patterns.     

ICU护理人员岗位胜任特征模型的构建

目的 构建ICU护理人员岗位胜任特征模型,为专科护理人员甄选、培训和绩效考核提供科学依据。方法 根据文献分析和专家咨询结果,建立ICU护理人员岗位胜任特征词典,利用行为事件访谈法对26名ICU护理人员进行访谈,采用自编问卷调查200名ICU护理人员,对各胜任特征项目重要程度进行态度评价。结果 所建立的ICU护理人员岗位胜任特征模型共包含15项鉴别胜任特征和7项基准胜任特征,归类一致性系数0.839。结论 所构建的ICU护理人员岗位胜任特征模型具有较好的信度和效度。