Development of clinical teaching competency framework and scale for physician teachers in China: an exploratory sequential mixed methods study

Physician teachers (PT) play a vital role in professional health education. However, there is a lack of a theoretical framework to direct PT faculty development in China. Therefore, this study was designed to develop and validate a clinical teaching competency framework and scale (CTCS) for physicians in China. This mixed-methods study began with qualitative interviews and a Delphi process to develop an initial framework and a pretest version of the Clinical Teaching Competency Scale (CTCS). Using convenience and random sampling, 450 physician teachers (PTs) were selected as the prediction sample. A national survey involving 3,179 PTs from seven administrative regions in Mainland China served as the validation sample. Exploratory and confirmatory factor analyses were conducted to assess construct validity. Seven dimensions were identified. Namely, intellectual literacy, clinical curriculum teaching competence, clinical practice teaching competence, role modeling, clinical teaching choice ability, clinical teaching emotional ability, and clinical teaching independent development ability. These explained 70.513% of the total variance. The final scale comprised 54 items, with a Cronbach's alpha of 0.987. Confirmatory factor analysis showed acceptable fit indices: RMSEA = 0.065, SRMR = 0.038, and GFI, NFI, IFI, TLI, and CFI all > 0.9. Construct reliability (CR) for each dimension exceeded 0.9, and average variance extracted (AVE) ranged from 0.672 to 0.832, indicating strong reliability and validity. A pyramid model with seven domains and 54 items was developed using a mixed-methods approach. This framework can guide the training of physician teachersand ultimately support health and well-being. The CTCS demonstrates acceptable reliability and validity, making it a valuable tool for assessing the clinical teaching competence of physician teachers.