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[欧洲医学专家医生的终身学习:继续医学教育、直接病人护理与资格认证]

[Long-life learning for medical specialists doctors in Europe: CME, DPC and qualification].

作者信息

Maillet Bernard, Maisonneuve Hervé

机构信息

Union européenne des médecins spécialistes, 1050 Bruxelles, Belgique.

出版信息

Presse Med. 2011 Apr;40(4 Pt 1):357-65. doi: 10.1016/j.lpm.2011.01.014. Epub 2011 Mar 3.

Abstract

The Union européenne des médecins spécialistes (UEMS) has a mandate to lead the quality of care in Europe and harmonise the qualifications of specialists doctors. In 2000, UEMS has set the European Accreditation Council for Continuing Medical Education (EACCME), with the objective to accredit educational events and facilitate the reciprocity of CME credits obtained by attending international medical conferences. In 2010, UEMS has set the European Accreditation Council for Medical Specialist Qualification (EACMSQ). This 2-year pilot project concerns three specialties with the goal to harmonise the competencies' assessment. In 2010, 35 countries are UEMS members, corresponding to 1,5 millions specialists doctors. Each of the 38 medical specialties has a 'section' and a four-members' board. Since 2000, the Europe developed the CPD concepts, and definitions were customised per country and health systems. The Rome group defined the CPD: "Continuing professional development is the educative means of updating, developing and enhancing how doctors apply the knowledge, skills and attitudes required in their working lives. This includes CME, professional and managerial (non-clinical) competencies, and all elements of Good Medical Practice". The learning concepts must be better developed in the health care systems as it has been done in other sectors of activity. Learning is the concept considering that it's no more possible to characterise the learner as a sponge absorbing information. The virtuous cycle of CME is well-known: assess his professional needs; set the needs and objectives; implement an educational plan with the right methods; conduct the actions and get the data; assess the events according to levels (participation, satisfaction, learning, performance, patient's health, population's health). Financing of events usually is shared between payers: state, insurers, industries, doctors but in fine, the public is the major payer. Education must be independent from all influences and recommendations should be set. Countries have mandatory or voluntary CME/CPD systems but it's not a criterium of a better performance. National authorities accredit organisms or events, and that does not make any difference.

摘要

欧洲医学专家联盟(UEMS)的职责是引领欧洲的医疗质量并协调专科医生的资质。2000年,UEMS设立了欧洲继续医学教育认证委员会(EACCME),目的是对教育活动进行认证,并促进通过参加国际医学会议获得的继续医学教育学分的互认。2010年,UEMS设立了欧洲医学专家资质认证委员会(EACMSQ)。这个为期两年的试点项目涉及三个专业,目标是协调能力评估。2010年,有35个国家是UEMS成员,对应150万名专科医生。38个医学专业中的每一个都有一个“部门”和一个由四名成员组成的委员会。自2000年以来,欧洲发展了继续职业发展(CPD)概念,并且定义是根据每个国家和卫生系统量身定制的。罗马小组对CPD的定义是:“继续职业发展是更新、发展和提升医生在工作中应用所需知识、技能和态度方式的教育手段。这包括继续医学教育、专业和管理(非临床)能力以及良好医疗实践的所有要素”。学习概念在医疗保健系统中必须得到更好的发展,就像在其他活动领域所做的那样。学习是一个概念,因为不再可能将学习者描述为吸收信息的海绵。继续医学教育的良性循环是众所周知的:评估他的专业需求;确定需求和目标;用正确的方法实施教育计划;开展行动并获取数据;根据不同层面(参与度、满意度、学习、表现、患者健康、人群健康)评估活动。活动的资金通常由付款方分担:国家、保险公司、行业、医生,但最终,公众是主要付款方。教育必须独立于所有影响,并应制定建议。各国都有强制性或自愿性的继续医学教育/继续职业发展系统,但这不是表现更好的标准。国家当局对机构或活动进行认证,这没有任何区别。

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