Yaszay Burt, Kubiak Erik, Agel Julie, Hanel Douglas P
Rady's Children's Hospital of San Diego, San Diego, California 92123, USA.
Orthopedics. 2009 Mar;32(3):171.
Beginning in July 2002, the Accreditation Council for Graduate Medical Education (ACGME) instructed all residency programs to require their residents to demonstrate competency in 6 core areas: patient care, interpersonal and communication skills, medical knowledge, professionalism, practice-based learning, and systems-based practice. The goal was to have objective markers of performance that would serve as a gauge to determine a program's accreditation. To determine the experiences of orthopedic residency programs with regard to the ACGME's core competencies, a national survey was administered to orthopedic program directors and selected orthopedic residents. Of those orthopedic programs that responded, most appeared to be complying with the ACGME requirements. Both directors and residents thought patient care and medical knowledge ranked most important, while practice-based learning and systems-based practice were assigned the lowest ranks. Barriers to implementation of the core competencies included low priority compared with clinical duties, lack of faculty or resident education, and lack of formal orthopedic core competencies. Residents and program directors agreed that their programs would benefit from a definition of each of the core competencies, including a greater commitment to the processes involved in surgical procedures. This study demonstrated a commitment to the core competencies by the programs that responded. The survey also suggested this commitment would be aided by improved definitions of some of the competencies for the orthopedic resident.
从2002年7月开始，毕业后医学教育认证委员会（ACGME）指示所有住院医师培训项目要求其住院医师在6个核心领域展示能力：患者护理、人际沟通技能、医学知识、职业素养、基于实践的学习以及基于系统的实践。目标是拥有表现的客观指标，作为确定项目认证的衡量标准。为了确定骨科住院医师培训项目在ACGME核心能力方面的情况，对骨科项目主任和选定的骨科住院医师进行了一项全国性调查。在做出回应的骨科项目中，大多数似乎都符合ACGME的要求。主任和住院医师都认为患者护理和医学知识最为重要，而基于实践的学习和基于系统的实践排名最低。实施核心能力的障碍包括与临床职责相比优先级较低、缺乏教员或住院医师教育以及缺乏正式的骨科核心能力。住院医师和项目主任一致认为，他们的项目将受益于对每个核心能力的定义，包括对手术程序所涉及过程的更大投入。这项研究表明做出回应的项目对核心能力的承诺。调查还表明，对骨科住院医师某些能力的定义进行改进将有助于这种承诺的实现。
