【摘要】 在国家“破四唯”政策背景下，探索公立医院如何重构医师能力评价体系。本研究旨在探究评价导向错位所导致的组织与医师间“心理契约”侵蚀的深层机制，并以此为切入点助推医院高质量发展。通过系统梳理相关文件、国外主流医师胜任力模型以及组织行为学理论，在融入本土医院管理经验的基础上，构建契合我国国情的多维胜任力框架；并设计与之匹配的评估矩阵。该模型包含临床卓越、学术探究、协同领导与职业人文4个方面，并通过形成性、纵向追踪及总结性3种评估工具展开量化测量。核心观点认为，从以“四唯”为主导的评价体系转变为以胜任力为主导的评价体系，能校准组织激励导向与医师职业核心价值、修复“心理契约”,进而为医院落实“健康中国”战略目标奠定基础的关键路径。更多还原

【Abstract】 Against the backdrop of the national policy to “break the four only”, this study seeks to explore how public hospitals can reconstruct their physician competency evaluation systems. It aims to investigate the underlying mechanisms of the erosion of the “psychological contract” between organizations and physicians caused by misaligned evaluation priorities, using this insight as a starting point to propel high-quality hospital development. By systematically reviewing relevant documents, mainstream international physician competency models, and organizational behavior theories, and integrating local hospital management experience, we construct a multidimensional competency framework tailored to China’s context. A corresponding assessment matrix is designed. This model encompasses four dimensions: Clinical Excellence, Academic Inquiry, Collaborative Leadership, and Professional Humanism, and employs three assessment tools—formative, longitudinal tracking, and summative—for quantitative measurement. The core argument posits that shifting from an evaluation system dominated by the “Four Exclusives” to one centered on competency is a critical pathway to recalibrate organizational incentive structures with physicians’ core professional values, restore the “psychological contract, ” and thereby lay the foundation for hospitals to implement the strategic goals of the “Healthy China” initiative.更多还原