Davis Deborah J, Ringsted Charlotte, Bonde Mie, Scherpbier Albert, van der Vleuten Cees
Centre for Clinical Education, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Eur Child Adolesc Psychiatry. 2009 Jan;18(1):33-41. doi: 10.1007/s00787-008-0700-1. Epub 2008 Jun 10.
Learning during residency in child and adolescent psychiatry (CAP) is primarily work-based and has traditionally been opportunistic. There are increasing demands from both postgraduate trainees and medical organisations for structured programmes with defined learning outcomes.
The aim of this study was to partner with postgraduate trainees and consultants in psychiatry to identify key learning issues that should be considered during CAP residency and to use these in designing a structured programme to meet the learning outcome requirements of a competency framework.
Participatory design was used to structure a learning and assessment programme in CAP. First, during working seminars, consultants and postgraduate trainees were interviewed about the characteristics of the learning and working in CAP. These interviews were audio taped, transcribed and analyzed for recurrent themes to identify key issues. Descriptive results were fed back to the participants for validation. In a subsequent iterative process the researchers and practitioners partnered to construct a learning and assessment programme.
The tasks within CAP were poorly described by study participants. Several other types of professionals within the healthcare team perform many of the tasks a CAP postgraduate trainee has to learn. Participants had difficulties describing how learning takes place and what postgraduate trainees need to learn in CAP. The partnership between researchers and practitioners identified three key issues to consider in CAP residencies: (1) Preparation for tasks postgraduate trainees are expected to fulfil, (2) Ensuring acquisition of physician-specific knowledge and skills, and (3) Clarifying roles and professional identity within the team. A structured training programme incorporating the key learning issues identified was created.
Participatory design was very helpful to structure a contextually suitable training programme in CAP. The researchers speculate that this approach will result in easier implementation of the new training programme.
儿童与青少年精神病学（CAP）住院医师培训期间的学习主要基于工作，传统上具有机会主义性质。研究生学员和医学组织对具有明确学习成果的结构化课程的需求日益增加。
本研究的目的是与精神病学研究生学员和顾问合作，确定CAP住院医师培训期间应考虑的关键学习问题，并将其用于设计一个结构化课程，以满足能力框架的学习成果要求。
采用参与式设计来构建CAP的学习与评估课程。首先，在工作研讨会上，就CAP学习与工作的特点对顾问和研究生学员进行访谈。对这些访谈进行录音、转录并分析反复出现的主题，以确定关键问题。将描述性结果反馈给参与者进行验证。在随后的迭代过程中，研究人员和从业者合作构建了一个学习与评估课程。
研究参与者对CAP中的任务描述不佳。医疗团队中的其他几种专业人员执行许多CAP研究生学员必须学习的任务。参与者难以描述学习是如何发生的以及研究生学员在CAP中需要学习什么。研究人员和从业者之间的合作确定了CAP住院医师培训中要考虑的三个关键问题：（1）为研究生学员预期完成的任务做好准备；（2）确保获得特定于医生的知识和技能；（3）明确团队中的角色和职业身份。创建了一个纳入已确定关键学习问题的结构化培训课程。
参与式设计对于构建适合CAP背景的培训课程非常有帮助。研究人员推测，这种方法将使新培训课程更容易实施。
