Robinson Susan, Boursicot Katharine, Hayhurst Catherine
Emergency Department (Box 87), Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
Emerg Med J. 2007 Mar;24(3):180-4. doi: 10.1136/emj.2006.038406.
In our region, it was acknowledged that the process of assessment needed to be improved, but before developing a system for this, there was a need to define the "competent or satisfactory trainee".
To outline the process by which a consensus was achieved on this standard, and how a system for formally assessing competency across a wide range of knowledge skills and attitudes was subsequently agreed on, thus enabling increased opportunities for training and feedback and improving the accuracy of assessment in the region.
The opinions of trainees and trainers from across the region were collated, and a consensus was achieved with regard to the minimum acceptable standard for a trainee in emergency medicine, thus defining a competent trainee. The group that set the standard then focused on identifying the assessment methods most appropriate for the evaluation of the knowledge, skills and attitudes required of an emergency medicine trainee. The tool was subsequently trialled for a period of 6 months, and opinion evaluated by use of a questionnaire.
The use of the tool was reviewed from both the trainers' and trainees' perspectives. 42% (n = 11) of trainers and 31% (n = 8) trainees responded to the questionnaire. In the region, there were 26 trainers and 26 trainees. Five trainees and nine trainers had used the tool. 93% (14/15) of respondents thought that the descriptors used to describe the satisfactory trainee were acceptable; 89% (8/9) of trainers thought that it helped them assess trainees more accurately. 60% (3/5) of trainees thought that, as a result, they had a better understanding of their weak areas.
We believe that we achieved a consensus across our region as to what defined a satisfactory trainee and set the standard against which all our trainees would subsequently be evaluated. The use of this tool to assess trainees during the pilot period was disappointing; however, we were encouraged that most of those using the tool thought that it allowed an objective assessment of trainees and feedback on areas requiring further work. Those who used the tool identified important reasons that may have hindered widespread use of the assessment tool.
在我们这个地区，人们认识到评估过程需要改进，但在开发相关系统之前，有必要明确“合格或令人满意的实习生”的定义。
概述就这一标准达成共识的过程，以及随后如何就一个用于正式评估广泛知识、技能和态度方面能力的系统达成一致，从而增加培训和反馈的机会，并提高该地区评估的准确性。
整理了该地区实习生和培训师的意见，就急诊医学实习生的最低可接受标准达成了共识，从而明确了合格实习生的定义。设定标准的小组随后专注于确定最适合评估急诊医学实习生所需知识、技能和态度的评估方法。该工具随后进行了为期6个月的试用，并通过问卷对意见进行评估。
从培训师和实习生的角度对该工具的使用情况进行了审查。42%（n = 11）的培训师和31%（n = 8）的实习生回复了问卷。该地区有26名培训师和26名实习生。5名实习生和9名培训师使用了该工具。93%（14/15）的受访者认为用于描述令人满意的实习生的描述词是可以接受的；89%（8/9）的培训师认为这有助于他们更准确地评估实习生。60%（3/5）的实习生认为，因此他们对自己的薄弱环节有了更好的理解。
我们相信，我们在整个地区就如何定义令人满意的实习生达成了共识，并设定了随后将据此对所有实习生进行评估的标准。在试点期间使用该工具评估实习生的情况令人失望；然而，我们感到鼓舞的是，大多数使用该工具的人认为它能够对实习生进行客观评估，并就需要进一步改进的方面提供反馈。使用该工具的人指出了可能阻碍评估工具广泛使用的重要原因。
