Department of Pediatrics, University of California, Davis, School of Medicine, Sacramento, California, USA.
Acad Med. 2011 Oct;86(10):1293-9. doi: 10.1097/ACM.0b013e31822be22b.
To determine the types of learning goals residents select for their individualized learning plans (ILPs) and the relationship between goal type and progress toward achieving that goal.
Pediatric and combined pediatric residents at 46 U.S. training programs completed a Web-based survey on ILPs in 2008-2009, describing their most important learning goal and the goals on which they made the most and least progress. Using iterative inductive review, responses were categorized into seven types (six corresponding with the Accreditation Council for Graduate Medical Education general competencies). Descriptive statistics and regression models were used to assess the relationship between goal type and progress made.
Of 1,739 eligible residents, 992 (57%) completed the survey; 668 (38%) had previously completed an ILP and described their learning goals. Residents were more likely to report medical knowledge (MK) (53.7%) and patient care (PC) (25.9%) goals as most important and less likely to report professionalism (1.5%) and systems-based practice (SBP) (1.0%) goals as most important. Compared with progress on MK goals, residents reported significantly greater progress on PC (odds ratio [OR]: 2.20; 95% confidence interval [CI]: 1.57-3.09) and practice-based learning and improvement teaching (OR: 2.99; 95% CI: 1.59-5.63) goals and less progress on SBP goals (OR: 0.16; 95% CI: 0.05-0.56).
Residents most commonly identified MK and PC learning goals as the most important. Residents made more progress on goals related to everyday tasks, such as PC and teaching, compared with goals less integrated in everyday training, such as SBP.
确定住院医师为个体化学习计划(ILP)选择的学习目标类型,以及目标类型与实现该目标的进展之间的关系。
2008-2009 年,美国 46 个培训项目的儿科和儿科联合住院医师完成了一项基于网络的 ILP 调查,描述了他们最重要的学习目标,以及他们在哪些目标上取得的进展最多,哪些目标取得的进展最少。使用迭代归纳审查,将答复分为七种类型(与研究生医学教育认证委员会的六项一般能力相对应)。使用描述性统计和回归模型评估目标类型与取得进展之间的关系。
在 1739 名符合条件的住院医师中,有 992 名(57%)完成了调查;668 名(38%)之前完成过 ILP,并描述了他们的学习目标。住院医师更有可能报告医学知识(MK)(53.7%)和患者护理(PC)(25.9%)目标作为最重要的目标,而不太可能将专业精神(1.5%)和基于系统的实践(SBP)(1.0%)目标作为最重要的目标。与 MK 目标的进展相比,住院医师报告在 PC(优势比[OR]:2.20;95%置信区间[CI]:1.57-3.09)和基于实践的学习和改进教学(OR:2.99;95% CI:1.59-5.63)目标上取得了更大的进展,在 SBP 目标上取得的进展较小(OR:0.16;95% CI:0.05-0.56)。
住院医师最常将 MK 和 PC 学习目标确定为最重要的目标。与不太融入日常培训的目标(如 SBP)相比,住院医师在与日常任务相关的目标(如 PC 和教学)上取得了更大的进展。