University of Groningen, Wenckebach Institute, University Medical Center Groningen, Postgraduate School of Medicine, Groningen, the Netherlands.
Med Teach. 2012;34(8):e589-602. doi: 10.3109/0142159X.2012.670325. Epub 2012 Apr 10.
Postgraduate medical education (PGME) curricula are being redesigned across the western world.
This study examined the implementation process (what works where and why) of new competency-based PGME curricula and relevant factors influencing this process.
In a nationwide project (2006-2010) in the Netherlands, competency-based PGME curricula were implemented for residents in Pediatrics and Obstetrics & Gynecology. The authors conducted 25 semi-structured interviews and used a multi-level theoretical framework to guide coding.
The implementation process proved to be highly dynamic, non-linear, and influenced by many factors. These could be divided into attributes of the innovations/adopters, the implementation process, and the organization. The context determined the speed, quality, and direction of the process and how a factor affected the process.
We identified specific features of PGME innovation: the challenge of implementing other competencies than that of the medical expert; the importance of regional implementation strategies and educational support; the balance between training and patient care; and the need for regional inter-organizational networks of hospitals. The authors recommend: design the curriculum with the needs of the users in mind; facilitate knowledge sharing; organize educational support; translate the national curriculum to the local workplace; and promote regional inter-organizational networks between hospitals.
研究生医学教育（PGME）课程在整个西方世界都在进行重新设计。
本研究考察了新的基于能力的 PGME 课程的实施过程（在何处以及为何有效）以及影响这一过程的相关因素。
在荷兰的一个全国性项目（2006-2010 年）中，为儿科和妇产科的住院医师实施了基于能力的 PGME 课程。作者进行了 25 次半结构化访谈，并使用多层次理论框架来指导编码。
实施过程被证明是高度动态的、非线性的，并受到许多因素的影响。这些因素可以分为创新者/采用者的属性、实施过程和组织。背景决定了过程的速度、质量和方向，以及一个因素如何影响过程。
我们确定了 PGME 创新的具体特征：实施除医学专家能力以外的其他能力的挑战；区域实施策略和教育支持的重要性；培训和患者护理之间的平衡；以及需要医院之间的区域组织间网络。作者建议：根据用户的需求设计课程；促进知识共享；组织教育支持；将国家课程转化为当地工作场所；并促进医院之间的区域组织间网络。
