Balmer Dorene F, Lisby Dee'ann, Harris Mary Catherine, Slap Gail B
Center for Education Research and Evaluation, Columbia University Medical Center, 710W 168th Street, Room LL-10A, New York, NY 10032, USA.
Med Teach. 2008;30(7):687-92. doi: 10.1080/01421590802047240.
Six general competencies form the framework for accreditation of postgraduate fellowship programs and maintenance of certification for physician specialists. Fellows' perceptions of these competencies, however, remain unexplored.
To examine fellows' perceptions of the importance of the competencies to medical education and the contribution of fellowship training to mastery of the competencies, and to explore the alignment of the competencies with critical learning experiences.
Semi-structured interviews were conducted with 20 pediatric fellows in five divisions at one institution. Fellows recounted critical learning experiences, rated each competency for importance and contribution of training, and explained their ratings. Interviews were analyzed using standard qualitative methods.
Fellows assigned high ratings to medical knowledge and patient care for importance and contribution of training to mastery, referring to these competencies as 'staples of training'. They rated interpersonal and communication skills and professionalism higher for importance than contribution of training, viewing them as inherent traits or learned before fellowship. Fellows were unfamiliar with practice-based learning and improvement and systems-based practice and typically perceived them as secondary to training. Descriptions of critical learning experiences substantiated competency ratings for medical knowledge and patient care, but not practice-based learning and improvement.
Fellows perceive traditional knowledge and skills of medical practice as fundamental to postgraduate training, but other competencies as less central.
六项通用能力构成了研究生专科培训项目认证及医师专科医生资质维持的框架。然而，学员对这些能力的看法仍未得到探究。
考察学员对这些能力在医学教育中的重要性的看法，以及专科培训对掌握这些能力的贡献，并探究这些能力与关键学习经历的匹配度。
对一所机构五个科室的20名儿科住院医师进行了半结构化访谈。住院医师讲述了关键学习经历，对每项能力在培训重要性和贡献方面进行评分，并解释他们的评分。采用标准定性方法对访谈进行分析。
住院医师对医学知识和患者护理在培训重要性和对掌握能力的贡献方面给予高分，将这些能力称为“培训的主要内容”。他们认为人际沟通技能和职业素养在重要性方面高于培训贡献，将其视为固有特质或在专科培训之前就已习得。住院医师对基于实践的学习与改进以及基于系统的实践不熟悉，通常认为它们在培训中处于次要地位。对关键学习经历的描述证实了医学知识和患者护理能力的评分，但未证实基于实践的学习与改进能力的评分。
住院医师认为医学实践的传统知识和技能是研究生培训的基础，但其他能力则不那么核心。
