Department of Pediatrics, University of Colorado School of Medicine and The Children's Hospital, Aurora, Colorado 80045, USA.
Acad Med. 2011 Feb;86(2):161-5. doi: 10.1097/ACM.0b013e31820442e9.
Regulatory organizations have recently emphasized the importance of structuring graduate medical education around mastery of core competencies. The difficulty is that core competencies attempt to distill a range of professional behaviors into arguable abstractions. As such, competencies can be difficult to grasp for trainees and faculty, who see them as unrelated to the intricacies of daily patient care. In this article, the authors describe how two initiatives are converging in a way that should make competencies tangible and relevant. One initiative is based on the idea that competencies will be more meaningful if trainees understand specifically how they relate to important professional activities in their own specialty. The authors suggest that there is a dyadic relationship between competencies and major professional activities in pediatric medicine. They also suggest that these relationships should be discussed as part of the process by which trainees are entrusted to perform clinical activities without direct supervision. The other initiative proposes to construct narrative milestones that provide a picture of what progression toward mastery of core competencies might look like. Together, the authors argue, these two initiatives should illuminate the core competencies by providing relevant clinical context and valuable educational substance.
监管机构最近强调了围绕核心能力来构建住院医师规范化培训的重要性。但困难在于，核心能力试图将一系列专业行为提炼为可争论的抽象概念。因此，对于学员和教师来说，这些能力很难理解，他们认为这些能力与日常患者护理的复杂性无关。在本文中，作者描述了两项举措如何以一种应该使能力变得有形和相关的方式汇聚在一起。一项举措基于这样一种观点，即如果学员具体了解它们与自己专业领域的重要专业活动的关系，那么能力将更有意义。作者认为，在儿科学中，能力和主要专业活动之间存在着一种对偶关系。他们还建议，应该在委托学员在没有直接监督的情况下进行临床活动的过程中讨论这些关系。另一项举措提议构建叙述性里程碑，以提供掌握核心能力进展的情况。作者认为，这两项举措应该通过提供相关的临床背景和有价值的教育内容来阐明核心能力。
