[住院医师培训质量的监测与改进：以医院中央教学委员会为主导？]

[Monitoring and improving the quality of residency training: the hospital's central teaching committee as director?].

作者信息

Lombarts M J M H Kiki, Scherpbier Albert J J A, Heineman Maas Jan

机构信息

Academisch Medisch Centrum, Afd. Kwaliteit en Proces Innovatie, Amsterdam, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2011;155(49):A3793.

PMID:22166178

Abstract

OBJECTIVE

The Central Teaching Committees (CTCs) of Dutch medical teaching institutions have, since January 1st 2011, the role of "director of medical residency training programmes" and as such are legally required to maintain and promote a positive and safe training environment. This study explores how CTCs are fulfilling their new role.

DESIGN

Questionnaire study.

METHODS

We developed a questionnaire to investigate the role of CTCs in assuring and improving the quality of the offered residency training. The questionnaire covered the general characteristics of the teaching institution and its CTC, the functioning of the CTCs including the attention given to quality management of residency training and the level of compliance with 6 quality standards. The first 2 parts contained mostly closed questions and questions concerning quality standards were scored on a 5-point scale. In the period December 2010-February 2011 the questionnaire was sent to 57 CTCs of academic and non-academic teaching hospitals in the Netherlands, addressed to the chair of the CTC; non-respondents were reminded up to 3 times.

RESULTS

The response rate was 86%. In assuring and improving the quality of residency training CTCs fulfilled different roles, such as stimulating (77.1%), policy making (60.4%), enforcement (50.0%) and execution (27.1%). In 2010, all CTCs had considered quality management subjects during their meetings. Activities most often reported were peer review (61.0%), evaluating the learning climate (53.3%) and feedback to individual teaching faculty (36.7%). The level of compliance with the 6 quality standards varied from an average of 1.78 (creating an optimal learning climate) to 3.21 (enabling internal quality assessment). The top clinical teaching hospitals rated themselves highest.

CONCLUSION

Quality assurance of residency training has the attention of CTCs, but systematic quality management is still in its infancy.

摘要

目的

自2011年1月1日起，荷兰医学教学机构的中央教学委员会（CTC）承担“住院医师培训项目主任”的角色，因此法律要求其维护和促进积极且安全的培训环境。本研究探讨了中央教学委员会如何履行其新角色。

设计

问卷调查研究。

方法

我们设计了一份问卷，以调查中央教学委员会在确保和提高所提供的住院医师培训质量方面的作用。问卷涵盖了教学机构及其中央教学委员会的一般特征、中央教学委员会的运作情况，包括对住院医师培训质量管理的关注以及对6项质量标准的遵守程度。前两部分主要包含封闭式问题，关于质量标准的问题采用5分制评分。在2010年12月至2011年2月期间，问卷被发送至荷兰学术和非学术教学医院的57个中央教学委员会，收件人为中央教学委员会主席；对未回复者最多提醒3次。

结果

回复率为86%。在确保和提高住院医师培训质量方面，中央教学委员会发挥了不同的作用，如激励（77.1%）、政策制定（60.4%）、执行（50.0%）和实施（27.1%）。2010年，所有中央教学委员会在会议期间都考虑了质量管理主题。最常报告的活动是同行评审（61.0%）、评估学习氛围（53.3%）以及向个别教师提供反馈（36.7%）。对6项质量标准的遵守程度各不相同，从平均1.78（营造最佳学习氛围）到3.21（实现内部质量评估）。顶级临床教学医院对自身的评价最高。