Khera N, Stroobant J, Primhak R A, Gupta R, Davies H
Sheffield Children's Hospital NHS Trust, Western Bank, Sheffield S10 2TH, UK.
Med Educ. 2001 Oct;35(10):957-66.
When training for junior doctors is being planned, little discussion is focused on what outcomes hospitals are trying to achieve with regard to education/training, i.e. on what makes the ideal hospital doctor. Instead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job description). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospital doctor, what they feel can be done to help realize this vision, and how they feel about their own training.
This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs), four each from the North Trent and South Thames rotations over a period of 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires.
A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clinically related generic/non-clinical skills; self-directed learning and medical education; implementing change management; applying strategic and organizational skills in career planning; consultation skills; research; and key personal attributes.
SpRs are articulate in expressing their own expectations of their training and have considerable insight into the components of good training. Further improvement could be made and will require significant commitment from both trainees and trainers.
在规划初级医生培训时，很少有人讨论医院在教育/培训方面想要达成什么样的成果，即理想的医院医生应具备哪些特质。相反，主要关注点在于皇家医学院教学大纲的要求（认证）以及服务提供的要求（工作描述）。目前的文献中没有关于长期定性研究的内容，即没有询问中级医生对于理想医院医生的愿景、他们认为可以采取哪些措施来实现这一愿景，以及他们对自身培训的看法。
本研究主要考察了通过对八名专科住院医生（SpRs）进行一系列半结构化访谈收集的数据，这些医生分别来自北特伦特和南泰晤士地区，各四人，访谈持续了18个月。另外还从焦点小组、对项目主任的访谈以及问卷调查中获取了信息。
构建了一个模型，该模型体现了专科住院医生对理想医院医生关键特质的看法以及如何在培训中实现这些特质。确定了八个广泛的领域：临床知识与技能；关键的临床相关通用/非临床技能；自主学习与医学教育；实施变革管理；在职业规划中应用战略和组织技能；咨询技能；研究；以及关键的个人特质。
专科住院医生能够清晰地表达他们对自身培训的期望，并且对良好培训的组成部分有相当深刻的见解。可以进一步改进，这将需要学员和培训师双方做出重大努力。
