Silver Ivan, Campbell Craig, Marlow Bernard, Sargeant Joan
Office of Continuing Education & Professional Development, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Contin Educ Health Prof. 2008 Winter;28(1):25-31. doi: 10.1002/chp.152.
Several recent studies highlight that physicians are not very accurate at assessing their competence in clinical domains when compared to objective measures of knowledge and performance. Instead of continuing to try to train physicians to be more accurate self-assessors, the research suggests that physicians will benefit from learning programs that encourage them to reflect on their clinical practice, continuously seek answers to clinical problems they face, compare their knowledge and skills to clinical practice guidelines and benchmarks, and seek feedback from peers and their health care team.
This article describes the self-assessment learning activities of the College of Family Physicians of Canada Maintenance of Proficiency program (Mainpro) and the Royal College of Physicians and Surgeons of Canada Maintenance of Certification program. (MOC) RESULTS: The MOC and the Mainpro programs incorporate several self-evaluation learning processes and tools that encourage physicians to assess their professional knowledge and clinical performance against objective measures as well as guided self-audit learning activities that encourage physicians to gather information about their practices and reflect on it individually, with peers and their health care team. Physicians are also rewarded with extra credits when they participate in either of these kinds of learning activities.
In the future, practice-based learning that incorporates self-assessment learning activities will play an increasingly important role as regulators mandate that all physicians participate in continuing professional development activities. Research in this area should be directed to understanding more about reflection in practice and how we can enable physicians to be more mindful.
最近的几项研究表明，与知识和表现的客观衡量标准相比，医生在评估自己在临床领域的能力时并不十分准确。研究表明，与其继续试图训练医生成为更准确的自我评估者，医生将从学习项目中受益，这些项目鼓励他们反思自己的临床实践，不断寻求解决他们面临的临床问题的答案，将自己的知识和技能与临床实践指南和基准进行比较，并寻求同行和医疗团队的反馈。
本文描述了加拿大家庭医生学院能力维持项目（Mainpro）和加拿大皇家内科医师与外科医师学院认证维持项目（MOC）的自我评估学习活动。
MOC和Mainpro项目纳入了几个自我评估学习过程和工具，鼓励医生根据客观标准评估自己的专业知识和临床表现，以及引导式自我审核学习活动，鼓励医生收集有关自己实践的信息，并与同行和医疗团队一起进行个人反思。当医生参与这两种学习活动中的任何一种时，他们还会获得额外的学分。
未来，随着监管机构要求所有医生参与持续专业发展活动，结合自我评估学习活动的基于实践的学习将发挥越来越重要的作用。该领域的研究应致力于更深入地理解实践中的反思，以及如何使医生更加专注。
