Stirling Kevin, Hogg George, Ker Jean, Anderson Fiona, Hanslip Jennifer, Byrne Derek
Clincial Skills Centre, University of Dundee, Tayside, UK.
Clin Teach. 2012 Oct;9(5):285-9. doi: 10.1111/j.1743-498X.2012.00541.x.
A small percentage of medical trainees will have performance concerns identified within their clinical practice. These trainees require specific interventions to address these concerns. The Postgraduate Ward Simulation Exercise (PgWSE) was developed as a joint collaboration between the University of Dundee and NHS Education for Scotland (NES).
The PgWSE takes around 90 minutes to complete. It allows assessors to directly observe the performance of trainees within a simulated ward environment. Trainees are assessed individually on their ability to prioritise competing demands, work as part of a team and make safe informed clinical decisions.
The PgWSE is the first specific national intervention to support the assessment and remediation of trainee doctors in difficulty. Nine PgWSE scenarios have been developed to reflect clinical practice: three in general surgery, four in general medicine and two in medicine for the elderly. To enhance realism, simulated patients (SPs) are recruited and trained for each exercise. Standardised assessment tools were developed and validated for assessors to make individual and consensus judgements regarding a trainee's performance. Self-assessment of performance is used to disengage trainees from the simulated activity and to prepare them for constructive feedback.
The PgWSE has been shown to be a valuable tool for the management of trainee doctors in difficulty in Scotland. Although the PgWSE is time and resource intensive, it has been shown to have a positive impact on the remediation of trainees and in the provision of objective, detailed and comprehensive feedback to the referring deanery. Within NES there are four geographical centres led by a postgraduate dean with responsibility for supervision of postgraduate medical education.
一小部分医学实习生在临床实践中会出现表现方面的问题。这些实习生需要特定的干预措施来解决这些问题。研究生病房模拟演练（PgWSE）是由邓迪大学和苏格兰国民保健服务教育部门（NES）联合开展的合作项目。
PgWSE大约需要90分钟完成。它使评估人员能够在模拟病房环境中直接观察实习生的表现。对实习生在区分相互竞争的需求优先级、团队协作以及做出安全明智的临床决策方面的能力进行单独评估。
PgWSE是首个支持对有困难的实习医生进行评估和补救的全国性特定干预措施。现已开发出九个PgWSE场景以反映临床实践：三个普通外科场景、四个普通内科场景以及两个老年医学场景。为增强真实感，每次演练都会招募并培训模拟患者（SP）。开发并验证了标准化评估工具，供评估人员就实习生的表现做出个人判断和达成共识的判断。使用表现自我评估来使实习生从模拟活动中脱离出来，并为他们接受建设性反馈做好准备。
PgWSE已被证明是苏格兰管理有困难的实习医生的一项有价值的工具。尽管PgWSE耗费时间和资源，但已证明它对实习生的补救以及向转诊教务长提供客观、详细和全面的反馈有积极影响。在NES内部有四个地理中心，由一名研究生教务长领导，负责监督研究生医学教育。
