超声医学专业住院医师核心胜任力培养的教学体会

住院医师规范化培训制度是医学生毕业后教育的重要组成部分及核心内容,是提高医疗质量,保障民众健康的重要举措。超声医学作为重要的医学影像技术之一,临床应用十分广泛,在疾病诊断、治疗、疗效评估和随访中发挥了重要作用。超声医学专业住院医师具有专业性强,操作技能依赖性高的特点,需要扎实的解剖、病理、生理和广泛的临床基本知识,能够对脏器进行全面检查并快速判断异常征象,立即给出诊断和鉴别诊断。如何培养兼具六大核心胜任力的住院医师,各个住培基地的培养模式将影响区域所辐射的超声行业发展。本人作为一名年轻的住培教师,在基地教学主任指导下,重点分享我院住院医师培养的师资培养和住院医师核心胜任力培养,旨在促进同行交流,不断改进教学和培养能力,提升学员核心胜任力。     

疗养院住院医师培训制度浅议

住院医师培训是毕业后医学教育的一个重要组成部分。在这个阶段 ,根据培训计划 ,住院医师在上级医师的指导下进行临床实践 ,通过规范的要求和严格的考核 ,从而学习到某一认可的医学专科领域中合格医生所必需的知识、技能和态度[1] 。这一制度自德国于1 9世纪末实行以来 ,经过美国的大力推广和不断完善 ,已被世界各国医学界认可。实践证明 ,它是适应医学科学技术飞速发展的形势 ,提高住院医师理论水平及实际操作能力的必由之路[2 ] 。目前 ,在我国各大型医院都建立了一套比较完善的住院医师培训制度 ,在疗养院 ,住院医师培训尚缺乏一个完整的…     

浅谈妇产科住院医师规范化培训

妇产科住院医师规范化培训是优秀妇产科医生成长的必经之路。优秀的妇产科住院医师应具备较高的人文修养,善于处理医患关系;能了解妇产科疾病的相关基础知识,熟练掌握妇产科的基本操作,胜任常规手术:具有良好的逻辑思维与发散思维,将理论知识与临床实践相结合[1,2]。故本文对妇产科住院医师规范化培训的重要性,妇产科住院医师人文修养、临床技能、临床思维的培养和妇产科住院医师考核等方面总结如下。     

住院医师规范化培训制度建设启动

正2月13日,建立国家住院医师规范化培训制度工作会议在上海召开,启动了以5年制医学本科教育及3年住院医师培训为主要模式的住院医师规范化培训制度建设。住院医师规范化培训内容需包括医疗道德作风、临床实践技能、专业理论知识、人际沟通交流、医疗政策法规等全面的医学素养。除了"5+3"的主要模式,7年制、8年制等长学制医学类专业毕业生,可酌减或维持住院     

清单管理在住院医师情景模拟教学中的应用探讨

住院医师规范化培训是医学生毕业后教育的重要组成,对提高医师临床胜任力、保障医疗质量和患者安全极为重要,是国家继续医学教育(continuing medical education,CME)中举足轻重的战略部署。     

超声医学住院医师培训体会

超声医学是医学影像住院医师培训的重要内容之一。由于超声医学具有很强的实践性，因此在超声住院医师培训的过程中，首先要明确培训的目的，其次要合理安排培训的时间，第三要结合教学模型强化立体概念，第四要从操作、正常图像常见病入手练好基本功，第五要结合病例不断加深对超声影像的理解。做好以上几点对于提高住院医师超声医学培训的效果具有很重要的作用。     

康复医学专业住院医师临床培训方案的探讨

现代康复医学２０世纪８０年代初在我国刚刚起步,康复科住院医师培训有待规范化,科学化。本文就康复医学住院医师培训的原则,实施方案进行初步探讨。     

超声医学住院医师规范化培训模式的探讨

超声医学是超声学与医学结合,将超声技术应用于医学各部门而形成的学科,兼备诊断和治疗。因此,超声医学住院医师规范化培训,需要有针对性、有侧重点地设计个性化的培训方案和培训方法,同时要注重职业素养、沟通合作及教学能力的培养。本文详细阐述了我院超声医学住院医师规范化培训新模式的构建,以及在实际中的实施应用和取得的成绩与不足,旨在更好地培养综合能力符合要求的超声医学住院医师。     

PBL教学法在全科住院医师培训中的应用

以问题为基础的学习(PBL)方法，是一种以学生为主体的新型医学教育方法。近年来我院在全科医学住院医师训练中尝试了这种教学模式，收到了较好的效果。该教学法有效地培养了全科医学住院医师主动自学的习惯以及整合各学科知识与技能的技巧，提高了学生发现问题、分析问题和解决问题的能力。PBL教学法是有利于培养适合当今社会需要的高素质全科医学住院医师的必要教学手段。     

新型冠状病毒肺炎疫情防控期间住院医师核心胜任力调查研究

  目的  探讨新型冠状病毒肺炎(简称“新冠肺炎”)疫情作为突发干预因素对于不同阶段住院医师培养的影响,以及基于胜任力为核心的毕业后医学培养方案对住院医师能力培养的提升作用,为优化研究生阶段医学教育提供参考。  方法  在新冠肺炎疫情防控工作取得阶段性胜利后,采用问卷调查的方式对169名临床医学博士后及515名临床医学专业型研究生进行匿名网络问卷调查。分析临床医学博士后和专业型研究生对于核心胜任力的认知及自评差异。  结果  临床医学博士后回收有效问卷141份(83.43%,141/169),专业型研究生回收有效问卷264份(51.26%,264/515),两群体中,均超过85%的学员“认同”或“非常认同”疫情期间对于医生职业有了更深刻的理解。胜任力自评结果显示,除“自我提高”条目无差别外,其他条目临床医学博士后自评得分均显著高于专业型研究生(P均＜0.05)。  结论  新冠肺炎疫情作为突发干预因素,对住院医师胜任力认知具有提升作用;采用住院医师核心胜任力为核心的毕业后医学教育模式能够全面提升学员的综合能力,是有效的住院医师培养方案;建议院校教育阶段应注重住院医师职业规划教育,进一步探索与毕业后教育紧密结合的院校教育新模式。     

An Evaluation of Pediatric Residency Education in Conveying Immunization Knowledge

Background: The Accreditation Council of Graduate Medical Education now requires all pediatric residency training programs assess medical knowledge competency. Purpose: The goal of this project was to determine whether pediatric residency training using patient-based/experiential teaching made residents competent in the area of immunization knowledge or whether additional teaching strategies might need to be developed. Methods: Cross-sectional and longitudinal study designs were used to determine improvement in immunization knowledge on a multiple-choice quiz over the 3 years of residency training. Results: Both the cross-sectional and longitudinal data showed a statistically significant improvement in performance between residency training Years 1 and 2 but not between Years 2 and 3 on the quiz. This statistically significant relationship by year of training was seen despite the modest reliability of the short quiz and the sample size. Conclusions: This study shows that pediatric residency education using patient-based/experiential teaching is effective in teaching first year residents about immunization knowledge but is not as effective for 2nd- and 3rd-year residents. Other instructional methods such as computer-based cases could be employed during the 2nd and 3rd years.     

Obstetric and Gynecologic Ultrasound Curriculum and Competency Assessment in Residency Training Programs: Consensus Report

Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound in Medicine assembled a multisociety task force to develop a consensus‐based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national and international guidelines for the performance of obstetric and gynecologic ultrasound examinations and thus are intended to represent the minimum requirement for such training. By expert consensus, the curriculum was developed for each year of training, criteria for each competency assessment image were generated, the pass score was established at, or close to, 75% for each, and obtaining a set of 5 ultrasound images with pass score in each was deemed necessary for attaining each competency. Given the current lack of substantial data on competency assessment in ultrasound training, the task force expects that the criteria set forth in this document will evolve with time. The task force also encourages use of ultrasound simulation in residency training and expects that simulation will play a significant part in the curriculum and the competency assessment process. Incorporating this training curriculum and the competency assessment tools may promote consistency in training and competency assessment, thus enhancing the performance and diagnostic accuracy of ultrasound examination in obstetrics and gynecology.     

中国临床药师核心胜任力框架专家共识(2023)

在医院药学服务转型的新时代背景下,对临床药师参与“以病人为中心”的药学专业技术服务提出了更高标准和要求,胜任力标准的制定已成为国际趋势,但目前我国关于药师胜任力的研究较为匮乏且尚无临床药师的核心胜任力框架。为完善我国临床药师胜任力体系建设,中国医学科学院北京协和医院、美国中华医学基金会和中国医院协会药事专业委员会共同发起并组织药学、医学、教育和管理者等多学科领域专家,结合国内外相关研究进展和我国临床药学实践经验,采用改良德尔菲法制定了《中国临床药师核心胜任力框架专家共识(2023)》。该共识确定了临床药师应具备的核心胜任力框架,包括职业素养、知识技能、病人照护、沟通合作、教学能力和终生学习6项一级指标和22项二级指标及其对应释义,为我国临床药师的培养和能力提升提供了重要依据和探索方向。     

Outcome Assessment in Emergency Medicine—A Beginning: Results of the Council of Emergency Medicine Residency Directors (CORD) Emergency Medicine Consensus Workgroup on Outcome Assessment

This article is designed to serve as a guide for emergency medicine (EM) educators seeking to comply with the measurement and reporting requirements for Phase 3 of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. A consensus workshop held during the 2006 Council of Emergency Medicine Residency Directors (CORD) "Best Practices" conference identified specific measures for five of the six EM competencies—interpersonal communication skills, patient care, practice-based learning, professionalism, and systems-based practice (medical knowledge was excluded). The suggested measures described herein should allow for ease in data collection and applicability to multiple core competencies as program directors incorporate core competency outcome measurement into their EM residency training programs.     

Contrast-Enhanced Ultrasound: Development of Syllabus for Core Theoretical and Practical Competencies

Contrast-enhanced ultrasound (CEUS) is dependent on the observer's competencies, and thus, appropriate education and testing of individual competency is essential. The current international curriculum in CEUS is methodologically weak and lacks validated competency assessment tests. In this study, we aimed to develop a syllabus for core competencies in CEUS using the Delphi process and an international panel of experts. A core writing group constructed an initial draft of the syllabus based on the existing literature. Eight international experts in CEUS or medical education were recruited as Delphi panelists. The draft underwent iterative and anonymous Delphi rounds until a pre-defined level of consensus was reached. The final syllabus consisted of 16 items, which were indexed in two main domains and in procedural order. An expert-generated proposal for a syllabus of core CEUS competencies has been constructed via the Delphi process and may serve as framework for future development of a CEUS curriculum, including competency assessment tests.     

运用世界卫生组织康复胜任力架构研究适应体育教师学科教学内容知识

目的 运用世界卫生组织康复胜任力架构(RCF)探讨适应体育教师教学内容知识,以构建适应体育教师胜任力体系和基于胜任力的适应体育教师教育培训体系和鉴定方法。方法 运用RCF,参照美国《适应体育国家标准(第三版)》(APENS-3),对适应体育教师学科教学知识的结构和内容进行系统研究,构建适应体育教师专业核心胜任力。结果 基于RCF和教师教学活动,从实践领域(教学)和学习与发展领域(继续教育)的知识和技能出发,构建适应体育教师的教学相关核心胜任力;基于构成教育的5个领域：学生、教师、教学、课程、教学评价,构建适应体育教师学科教学知识的结构和内容。该胜任力架构可运用于适应体育教师职业教学能力鉴定、继续教育课程设置和继续教育能力培训、绩效评估等领域。结论 应用RCF并参照APENS-3,构建了适应体育教师的学科教学内容知识结构及其核心内容,可应用于适应体育教师教学能力鉴定、继续教育课程开发和胜任力培训,以及教学绩效评估。     

Application of the Medical Knowledge General Competency to Emergency Medicine

In February 1999, the Accreditation Council for Graduate Medical Education (ACGME) identified six general competencies as the basic educational goals required by all training programs for their residents. This places emphasis on educational outcome assessment in residency programs and in the accreditation process. A concomitant goal is to have increasingly valid, reliable assessments of the ability of a resident physician to provide safe, evidenced-based, humanistic medical care to their patients. To better define these competencies for the specialty of emergency medicine (EM), the Council of Emergency Medicine Residency Directors (CORD-EM) held a consensus conference in March 2002. This article reports the results of the Consensus Group for the core competency area of medical knowledge. This competency is already being well addressed in residency programs, but there has been inadequate documentation of a resident's knowledge base. The Consensus Group focused on many assessment methods to determine those having the best potential for use in EM programs. Assessment methods felt to be most appropriate for assessment of the medical knowledge base of a resident are presented, as are practical suggestions for incorporating these into EM programs.     

CORD‐AEUS: Consensus Document for the Emergency Ultrasound Milestone Project

In 2012, the Accreditation Council for Graduate Medical Education (ACGME) designated ultrasound (US) as one of 23 milestone competencies for emergency medicine (EM) residency graduates. With increasing scrutiny of medical educational programs and their effect on patient safety and health care delivery, it is imperative to ensure that US training and competency assessment is standardized. In 2011, a multiorganizational committee composed of representatives from the Council of Emergency Medicine Residency Directors (CORD), the Academy of Emergency Ultrasound of the Society for Academic Emergency Medicine (SAEM), the Ultrasound Section of the American College of Emergency Physicians (ACEM), and the Emergency Medicine Residents' Association was formed to suggest standards for resident emergency ultrasound (EUS) competency assessment and to write a document that addresses the ACGME milestones. This article contains a historical perspective on resident training in EUS and a table of core skills deemed to be a minimum standard for the graduating EM resident. A survey summary of focused EUS education in EM residencies is described, as well as a suggestion for structuring education in residency. Finally, adjuncts to a quantitative measurement of resident competency for EUS are offered.     

Critical care competencies

In the absence of nationally accepted critical care competencies, each educational institution providing critical care programmes is forced to define the essential competencies necessary for practice, leading to variations in expected practice and the emergence of 'postcode' competencies. This research report aims to build upon competency activity for all areas of nursing practice within critical care levels 1, 2 and 3. A functional analysis to elicit core critical care competency statements was conducted and a modified Delphi technique was used to generate consensus opinion from a pan-London purposive sample of nurses working in critical care. The functional analysis group identified four competency statements and elements of competencies. Consensus agreement of 80% was achieved with mean agreement scores that exceed 97%. A core critical care competency framework was refined and developed by expert nurses drawing on their own experience and knowledge of critical care nursing. The framework could be useful to: educationalists designing competency-based curricula; critical care managers as a tool for recruitment and retention and for education and training of staff; individual critical care nurses to facilitate continuous professional development.