Kahol Kanav, Huston Carrie, Hamann Jessica, Ferrara John J
J Grad Med Educ. 2011 Mar;3(1):95-9. doi: 10.4300/JGME-D-10-00103.1.
Health care continues to expand in scope and in complexity. In this changing environment, residents are challenged with understanding its intricacies and the impact it will have on their professional activities and careers.
Embedding each of the competency elements in residents in a meaningful way remains a challenge for many surgery residency program directors.
We established a nonclinical rotation to provide surgery postgraduate year-1 (PGY-1) residents with a structured, multifaceted, largely self-directed curriculum into which each of the 6 core competencies are woven. Posttesting strategies were established for most curricular experiences to ensure to the greatest possible extent that each resident will have achieved an acceptable level of understanding of each of the competency areas before being given credit for the rotation.
By uniformly exceeding satisfactory scores on respective objective analyses, residents demonstrated an increased (at least short-term) understanding of each of the assessed competency areas.
Our project sought to address a prior lack of opportunity for our residents to develop a sound foundation for our residents in systems-based practice. Our new rotation addresses systems-based practice in several different learning environments, including emergency medical service ride-along, sentinel event participation, and hospice visits. Several research projects have enhanced the overall learning program. Our experience shows that a rotation dedicated to competency training can provide an innovative and engaging means of teaching residents the value of each element.
医疗保健的范围和复杂性持续扩大。在这种不断变化的环境中，住院医师面临着理解其错综复杂之处以及它将对其专业活动和职业生涯产生的影响的挑战。
以有意义的方式将每项胜任力要素融入住院医师培训中，对许多外科住院医师培训项目主任来说仍是一项挑战。
我们设立了一个非临床轮转项目，为外科一年级住院医师（PGY-1）提供一个结构化、多方面且主要是自主学习的课程，将6项核心胜任力融入其中。为大多数课程体验制定了课后测试策略，以最大程度确保每位住院医师在该轮转项目获得学分之前，对每个胜任力领域都达到可接受的理解水平。
通过在各自的客观分析中均远超满意分数，住院医师对每个评估的胜任力领域的理解有所增强（至少在短期内）。
我们的项目旨在解决此前住院医师缺乏机会为基于系统的实践打下坚实基础的问题。我们新的轮转项目在几种不同的学习环境中涉及基于系统的实践，包括随急救医疗服务出诊、参与警讯事件以及临终关怀探访。多个研究项目提升了整体学习计划。我们的经验表明，专门用于胜任力培训的轮转项目能够提供一种创新且引人入胜的方式，向住院医师传授每个要素的价值。
