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定义家庭医学中的基于能力的评估目标:关键特征方法。

Defining competency-based evaluation objectives in family medicine: key-feature approach.

机构信息

Department of Family Medicine, University of Saskatchewan, Regina, Canada.

出版信息

Can Fam Physician. 2011 Oct;57(10):e373-80.

PMID:21998245
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3192103/
Abstract

OBJECTIVE

To develop key features for priority topics previously identified by the College of Family Physicians of Canada that, together with skill dimensions and phases of the clinical encounter, broadly describe competence in family medicine.

DESIGN

Modified nominal group methodology, which was used to develop key features for each priority topic through an iterative process.

SETTING

The College of Family Physicians of Canada.

PARTICIPANTS

An expert group of 7 family physicians and 1 educational consultant, all of whom had experience in assessing competence in family medicine. Group members represented the Canadian family medicine context with respect to region, sex, language, community type, and experience.

METHODS

The group used a modified Delphi process to derive a detailed operational definition of competence, using multiple iterations until consensus was achieved for the items under discussion. The group met 3 to 4 times a year from 2000 to 2007.

MAIN FINDINGS

The group analyzed 99 topics and generated 773 key features. There were 2 to 20 (average 7.8) key features per topic; 63% of the key features focused on the diagnostic phase of the clinical encounter.

CONCLUSION

This project expands previous descriptions of the process of generating key features for assessment, and removes this process from the context of written examinations. A key-features analysis of topics focuses on higher-order cognitive processes of clinical competence. The project did not define all the skill dimensions of competence to the same degree, but it clearly identified those requiring further definition. This work generates part of a discipline-specific, competency-based definition of family medicine for assessment purposes. It limits the domain for assessment purposes, which is an advantage for the teaching and assessment of learners. A validation study on the content of this work would ensure that it truly reflects competence in family medicine.

摘要

目的

开发之前由加拿大家庭医生学院确定的优先主题的关键特征,这些关键特征与技能维度和临床接触阶段一起,广泛描述家庭医学的能力。

设计

采用改良的名义群体方法,通过迭代过程为每个优先主题开发关键特征。

设置

加拿大家庭医生学院。

参与者

一个由 7 名家庭医生和 1 名教育顾问组成的专家组,他们都有评估家庭医学能力的经验。小组成员在地域、性别、语言、社区类型和经验方面代表了加拿大家庭医学的背景。

方法

该小组使用改良的德尔菲法,通过多次迭代,得出能力的详细操作性定义,直到达成正在讨论的项目的共识。该小组从 2000 年到 2007 年每年开会 3 到 4 次。

主要发现

该小组分析了 99 个主题,生成了 773 个关键特征。每个主题有 2 到 20 个(平均 7.8 个)关键特征;63%的关键特征集中在临床接触的诊断阶段。

结论

本项目扩展了之前关于为评估生成关键特征的过程的描述,并将该过程从书面考试的背景中去除。对主题的关键特征分析侧重于临床能力的更高阶认知过程。该项目没有将能力的所有技能维度定义到相同程度,但它清楚地确定了那些需要进一步定义的维度。这项工作生成了用于评估目的的家庭医学特定学科、基于能力的定义的一部分。它限制了评估目的的领域,这是对学习者的教学和评估的优势。对这项工作的内容进行验证研究将确保它真正反映家庭医学的能力。

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本文引用的文献

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Can Fam Physician. 2011 Sep;57(9):e331-40.
2
Problem-solving & decision-making in family practice.家庭医学中的问题解决与决策。
Can Fam Physician. 1979 Dec;25:1473-7.
3
An undergraduate paediatric curriculum based on clinical presentations and 'key features'.基于临床表现和“关键特征”的本科儿科课程。
J Paediatr Child Health. 2008 Nov;44(11):661-4. doi: 10.1111/j.1440-1754.2008.01377.x. Epub 2008 Aug 19.
4
Defining characteristics of educational competencies.教育能力的定义特征。
Med Educ. 2008 Mar;42(3):248-55. doi: 10.1111/j.1365-2923.2007.02996.x.
5
Defining core procedure skills for Canadian family medicine training.定义加拿大家庭医学培训的核心程序技能。
Can Fam Physician. 2005 Oct;51(10):1364-5.
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Assessing general practice clinical decision making skills: the key features approach.评估全科医疗临床决策技能:关键特征法
Aust Fam Physician. 2005 Dec;34(12):1059-61.
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A practical guide to assessing clinical decision-making skills using the key features approach.使用关键特征法评估临床决策技能的实用指南。
Med Educ. 2005 Dec;39(12):1188-94. doi: 10.1111/j.1365-2929.2005.02339.x.
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Adapting the Key Features Examination for a clinical clerkship.调整关键特征检查以用于临床实习。
Med Educ. 2002 Feb;36(2):160-5. doi: 10.1046/j.1365-2923.2002.01067.x.
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Defining and assessing professional competence.界定与评估专业能力。
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