Wijnen-Meijer Marjo, ten Cate Olle, van der Schaaf Marieke, Harendza Sigrid
Center for Research and Development of Education, University Medical Center Utrecht, the Netherlands.
Clin Teach. 2013 Jun;10(3):155-9. doi: 10.1111/tct.12022.
Vertical integration (VI) has been recommended as an undergraduate medical curriculum structure that fosters the transition to postgraduate training. Our definition of VI includes: (1) the provision of early clinical experience; (2) the integration of biomedical sciences with clinical cases; (3) long clerkships during the final year; and (4) increasing levels of clinical responsibility for students. The aim of the current study is to support the hypothesis that medical graduates from VI programmes meet the expectations of postgraduate supervisors better than those from non-VI curricula.
A questionnaire study was carried out among supervisors of postgraduate training programmes run at Utrecht (the Netherlands, VI; n = 128) and Hamburg (Germany, non-VI; n = 114). The supervisors were asked about their medical graduates' preparedness for work, knowledge and capabilities to manage some specific parts of the work as a doctor. They evaluated their performances on a five-point Likert scale.
The two groups of supervisors did not differ in their judgment of their graduates' preparedness for work and level of knowledge. However, supervisors in Utrecht evaluated their graduates higher with respect to capability to work independently, solving medical problems, managing unfamiliar medical situations, prioritising tasks, collaborating with other people, estimating when they need to consult their supervisors and reflecting on their activities.
Graduates from VI medical curricula appeared to be more capable in several facets of a doctor's job. Research into the actual performance of graduates from VI and non-VI curricula is needed to further support a firm recommendation for VI curricula.
垂直整合（VI）已被推荐作为一种本科医学课程结构，以促进向研究生培训的过渡。我们对垂直整合的定义包括：（1）提供早期临床经验；（2）将生物医学科学与临床病例相结合；（3）最后一年的长期临床实习；以及（4）增加学生的临床责任水平。本研究的目的是支持这样一种假设，即来自垂直整合课程的医学毕业生比来自非垂直整合课程的毕业生更能满足研究生导师的期望。
对荷兰乌得勒支（垂直整合课程；n = 128）和德国汉堡（非垂直整合课程；n = 114）的研究生培训项目导师进行了问卷调查。导师们被问及他们的医学毕业生在工作准备、知识以及管理医生工作某些特定部分的能力方面的情况。他们用五点李克特量表对毕业生的表现进行评估。
两组导师对毕业生工作准备情况和知识水平的判断没有差异。然而，乌得勒支的导师对他们毕业生在独立工作能力、解决医疗问题、处理不熟悉的医疗情况、任务优先级排序、与他人协作、判断何时需要咨询导师以及对自身活动进行反思等方面的评价更高。
来自垂直整合医学课程的毕业生在医生工作的几个方面似乎更有能力。需要对来自垂直整合和非垂直整合课程的毕业生的实际表现进行研究，以进一步支持对垂直整合课程的坚定推荐。
