Division of Neonatal Medicine, Mayo Clinic, Rochester, MN 55905, USA
J Crit Care. 2013 Feb;28(1):112.e1-5. doi: 10.1016/j.jcrc.2012.07.003. Epub 2012 Aug 9.
In 1999, the Accreditation Council for Graduate Medical Education identified 6 general competencies in which all residents must receive training. In the decade since these requirements went into effect, practice-based learning and improvement (PBLI) and systems-based practice (SBP) have proven to be the most challenging competencies to teach and assess. Because PBLI and SBP both are related to quality improvement (QI) principles and processes, we developed a QI-based curriculum to teach these competencies to our fellows.
This experiential curriculum engaged our fellows in our neonatal intensive care unit's (NICU's) structured QI process. After identifying specific patient outcomes in need of improvement, our fellows applied validated QI methods to develop evidence-based treatment protocols for our neonatal intensive care unit.
These projects led to immediate and meaningful improvements in patient care and also afforded our fellows various means by which to demonstrate their competence in PBLI and SBP. Our use of portfolios enabled us to document our fellows' performance in these competencies quite easily and comprehensively.
Given the clinical and educational structures common to most intensive care unit-based training programs, we believe that a QI-based curriculum such as ours could be adapted by others to teach and assess PBLI and SBP.
1999 年，研究生医学教育认证委员会确定了所有住院医师都必须接受培训的 6 项综合能力。自这些要求生效以来的十年中，实践基础学习和改进（PBLI）和基于系统的实践（SBP）已被证明是最难教授和评估的能力。由于 PBLI 和 SBP 都与质量改进（QI）原则和流程有关，因此我们开发了一个基于 QI 的课程，为我们的研究员教授这些能力。
本体验式课程使我们的研究员参与到新生儿重症监护病房（NICU）的结构化 QI 流程中。在确定需要改进的具体患者结果后，我们的研究员应用经过验证的 QI 方法为我们的新生儿重症监护病房制定基于证据的治疗方案。
这些项目立即为患者护理带来了有意义的改进，也为我们的研究员提供了多种展示其在 PBLI 和 SBP 方面能力的方式。我们使用组合投资来记录研究员在这些能力方面的表现，这非常简单和全面。
鉴于大多数基于重症监护病房的培训计划的临床和教育结构，我们相信，像我们这样的基于 QI 的课程可以被其他人采用来教授和评估 PBLI 和 SBP。
