Duggan C, Marks I, Richards D
Bethlem Royal and Maudsley Hospital.
Health Trends. 1993;25(1):25-30.
In health care training, professional examinations of competence test trainees' knowledge rather than their actual contribution to the improvement of patients' health. Clinical training programmes have the ultimate aim of improving patients' health, but rarely measure their success in attaining it. This paper provides an analysis of the results of clinical outcome for 2,032 patients treated during eight consecutive English National Board 650 courses, in which 68 nurse behaviour therapist trainees were trained at the Maudsley Hospital from 1978-91. The outcome of 668 patients treated in three recent courses (1987-91) is compared with that of 1,384 patients treated in five earlier courses (1978-86). Measures and diagnostic categories were similar over the whole study period. The trainees in 1987-91 achieved a similar health gain for most of their patients as did their counterparts in 1979-86, but this was achieved over a shorter time spent with each patient, and with greater effect in patients diagnosed as obsessive ruminators. These efficiency gains seem to reflect the incorporation into recent training of treatment advances in anxiety disorders.
在医疗保健培训中，专业能力考试考查的是学员的知识，而非他们对改善患者健康状况的实际贡献。临床培训项目的最终目标是改善患者健康，但很少衡量其在实现这一目标方面的成效。本文分析了在连续八门英国国家委员会650课程中接受治疗的2032名患者的临床结果，其中1978年至1991年期间有68名护士行为治疗学员在莫兹利医院接受培训。将最近三门课程（1987年至1991年）中治疗的668名患者的结果与前五门课程（1978年至1986年）中治疗的1384名患者的结果进行了比较。在整个研究期间，测量方法和诊断类别相似。1987年至1991年的学员为大多数患者带来的健康改善与1979年至1986年的学员相似，但这是在与每位患者相处时间较短的情况下实现的，并且对被诊断为强迫性沉思者的患者效果更佳。这些效率的提高似乎反映了近期培训中纳入了焦虑症治疗方面的进展。
