Wachtel Ruth E, Dexter Franklin
J Grad Med Educ. 2010 Dec;2(4):624-32. doi: 10.4300/JGME-D-10-00064.1.
Residency programs accredited by the ACGME are required to teach core competencies, including systems-based practice (SBP). Projects are important for satisfying this competency, but the level of knowledge and problem-solving skills required presupposes a basic understanding of the field. The responsibilities of anesthesiologists include the coordination of patient flow in the surgical suite. Familiarity with this topic is crucial for many improvement projects.
A course in operations research for surgical services was originally developed for hospital administration students. It satisfies 2 of the Institute of Medicine's core competencies for health professionals: evidence-based practice and work in interdisciplinary teams. The course lasts 3.5 days (eg, 2 weekends) and consists of 45 cognitive objectives taught using 7 published articles, 10 lectures, and 156 computer-assisted problem-solving exercises based on 17 case studies. We tested the hypothesis that the cognitive objectives of the curriculum provide the knowledge and problem-solving skills necessary to perform projects that satisfy the SBP competency. Standardized terminology was used to define each component of the SBP competency for the minimum level of knowledge needed. The 8 components of the competency were examined independently.
Most cognitive objectives contributed to at least 4 of the 8 core components of the SBP competency. Each component of SBP is addressed at the minimum requirement level of exemplify by at least 6 objectives. There is at least 1 cognitive objective at the level of summarize for each SBP component.
A curriculum in operating room management can provide the knowledge and problem-solving skills anesthesiologists need for participation in projects that satisfy the SBP competency.
经美国毕业后医学教育认证委员会（ACGME）认证的住院医师培训项目必须教授核心能力，包括基于系统的实践（SBP）。项目对于满足这一能力要求很重要，但所需的知识水平和解决问题的技能预先假定了对该领域的基本理解。麻醉医生的职责包括协调手术套房中的患者流程。熟悉这一主题对于许多改进项目至关重要。
一门针对外科服务的运筹学课程最初是为医院管理专业学生开发的。它满足了医学研究所对卫生专业人员的两项核心能力要求：循证实践和跨学科团队合作。该课程为期3.5天（例如，两个周末），包括45个认知目标，通过7篇已发表的文章、10次讲座以及基于17个案例研究的156个计算机辅助问题解决练习进行教学。我们检验了这样一个假设，即该课程的认知目标提供了执行满足SBP能力要求的项目所需的知识和解决问题的技能。使用标准化术语来定义SBP能力各组成部分所需的最低知识水平。对该能力的8个组成部分进行了独立考察。
大多数认知目标至少对SBP能力的8个核心组成部分中的4个有贡献。SBP的每个组成部分都至少通过6个目标在最低要求水平上得到体现。每个SBP组成部分都至少有1个处于总结水平的认知目标。
手术室管理课程可以提供麻醉医生参与满足SBP能力要求的项目所需的知识和解决问题的技能。
