Hagen Michael D, Ivins Douglas J, Puffer James C, Rinaldo Jason, Roussel Guy H, Sumner Walton, Xu Jinzhong
Department of Family and Community Medicine, University of Kentucky College of Medicine, American Board of Family Medicine, Lexington, KY 40505, USA.
J Am Board Fam Med. 2006 Jul-Aug;19(4):398-403. doi: 10.3122/jabfm.19.4.398.
In 2000, the American Board of Medical Specialties adopted Maintenance of Certification (MOC) to replace intermittent, periodic recertification. MOC consists of 4 components: demonstration of professionalism (part I); commitment to life-long learning (part II); demonstration of cognitive expertise (part III); and evaluation of performance in practice (part IV). The American Board of Family Medicine (ABFM) implemented Maintenance of Certification for Family Physicians (MC-FP) in 2004, with its MC-FP part II self-assessment modules (SAMs) as the focus of the first year's activities.
The SAMs use materials and resources provided at the ABFM's website (www.theabfm.org). As of April 2005, approximately 7000 Diplomates had successfully completed SAMs in essential hypertension (N = 2351) and type 2 diabetes mellitus (N = 4648). Participants completed categorical modified Likert scale evaluations to receive continuing education credit, and many offered unstructured free-text comments regarding the clinical simulation component. These free-text comments were entered into the AnSWR qualitative analysis program from the Centers for Disease Control and Prevention. Text coding was performed by 2 authors (MDH, DJI). As no inferential analyses or comparisons were anticipated, the authors conducted no studies of inter-rater consistency. Results are reported as means (SD) and medians for continuous data, and as frequencies for count data.
Likert-scale ratings indicated generally favorable responses (predominantly 5 to 6 on a 6-point scale) to the hypertension and diabetes SAMs. In addition, over half (ie, 55% for hypertension and 54% for diabetes participants) of the respondents indicated that the experience would lead to changes in their practices. Navigation and system operation issues predominated in the free-text comments offered for the diabetes and hypertension simulations.
The MC-FP SAMs received generally favorable ratings in the program's first year. The SAMs underwent a number of modifications and improvements during the first year, largely in response to feedback and suggestions from ABFM Diplomates.
2000年,美国医学专业委员会采用认证维持(MOC)来取代间歇性的定期再认证。MOC由4个部分组成:职业素养展示(第一部分);终身学习承诺(第二部分);认知专业能力展示(第三部分);以及实践表现评估(第四部分)。美国家庭医学委员会(ABFM)于2004年实施了家庭医生认证维持(MC-FP),其MC-FP第二部分自我评估模块(SAMs)成为第一年活动的重点。
SAMs使用ABFM网站(www.theabfm.org)提供的材料和资源。截至2005年4月,约7000名专科医师成功完成了原发性高血压(N = 2351)和2型糖尿病(N = 4648)的SAMs。参与者完成分类的改良李克特量表评估以获得继续教育学分,许多人还就临床模拟部分提供了非结构化的自由文本评论。这些自由文本评论被录入美国疾病控制与预防中心的AnSWR定性分析程序。文本编码由两位作者(MDH,DJI)进行。由于未预期进行推断性分析或比较,作者未进行评分者间一致性研究。结果以连续数据的均值(标准差)和中位数以及计数数据的频率报告。
李克特量表评分显示,对高血压和糖尿病SAMs的总体反应良好(在6分制中主要为5至6分)。此外,超过一半(即高血压参与者为55%,糖尿病参与者为54%)的受访者表示,该体验将导致他们的实践发生改变。在针对糖尿病和高血压模拟提供的自由文本评论中,导航和系统操作问题占主导。
MC-FP SAMs在该项目的第一年获得了总体良好的评分。在第一年中,SAMs进行了一些修改和改进,主要是为了回应ABFM专科医师的反馈和建议。