Altmaier E M, McGuinness G, Wood P, Ross R R, Bartley J, Smith W
Division of Psychological and Quantitative Foundations, College of Education, University of Iowa, Iowa City.
Pediatrics. 1990 Feb;85(2):139-43.
The pediatric literature has documented a growing attention to defining the nature and quality of residency training. The critical incident technique, a method widely accepted in industrial settings, was used in this study to determine attitudes and behaviors deemed critical for successful performance of residents in a pediatric training program. Structured interviews with 17 senior teaching faculty produced descriptions of resident behavior that were classified into the following mutually exclusive categories: commitment to learning, clinical judgment, communicating medical information, recognition of limits, professional behavior, interpersonal skills with patients, and dealing with emergency situations. Only 30% of the critical incidents obtained from the faculty were related to criteria traditionally used to select and evaluate residents, such as knowledge and technical skills, while the remaining incidents were noncognitive in nature. The results of this study have implications for the evaluation and selection of residents and suggest that pediatric program directors and faculty must give attention to the means by which noncognitive skills are fostered in residents.
儿科文献表明，人们越来越关注住院医师培训的性质和质量。关键事件技术是一种在工业环境中广泛接受的方法，本研究使用该技术来确定对于儿科培训项目中住院医师的成功表现至关重要的态度和行为。对17名资深教师进行的结构化访谈产生了对住院医师行为的描述，这些描述被分为以下相互排斥的类别：学习的投入、临床判断、医学信息沟通、认识到自身局限、职业行为、与患者的人际技能以及应对紧急情况。从教师那里获得的关键事件中，只有30%与传统上用于选拔和评估住院医师的标准相关，如知识和技术技能，而其余事件本质上是非认知性的。这项研究的结果对住院医师的评估和选拔具有启示意义，并表明儿科项目主任和教师必须关注培养住院医师非认知技能的方式。
