Steinhaeuser Jost, Chenot Jean-François, Roos Marco, Ledig Thomas, Joos Stefanie
Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstraße 2, Heidelberg, D-69115, Germany.
BMC Res Notes. 2013 Aug 9;6:314. doi: 10.1186/1756-0500-6-314.
Improving postgraduate medical training is one important step to attract more medical students into general practice. Keeping pace with international developments moving to competence-based curricula for general practice training, the aim of this project was to develop and implement such a curriculum in Germany.
A five-step, peer-based method was used for the curriculum development process including panel testing and a "test version" of the curriculum for the pilot implementation phase. The CanMEDS framework served as a basis for a new German competence-based curriculum in general practice training. Four curricula from European countries and Canada were reviewed and, following required cultural adaptions, key strengths from these were integrated. For the CanMEDS "medical expertise" element of the curriculum, the WONCA ICPC-2 classification of patient's "reason for encounters" was also integrated.
Altogether, 37 participants were involved in the development process representing 12 different federal states in Germany, and including an expert advisor from Denmark. An official "test version" of the curriculum consisting of three parts: medical expertise, additional competencies and medical procedures was established. A system of self-assessment for trainees was integrated into the curriculum using a traffic light scale. Since March 2012, the curriculum has been made freely available online as a "test version". In 2014, an evaluation is planned using feedback from users of the test model as a further stage of the implementation process.
The first German competence-based curriculum for general practice training has been developed using a pragmatic peer controlled approach and implementation is being trialed with a "test version" of the curriculum. This model project and its peer-based methodology may support competence-based curriculum development for other medical specialties both inside and outside Germany.
改善研究生医学培训是吸引更多医学生投身全科医疗的重要一步。为跟上向基于能力的全科医疗培训课程转变的国际发展步伐，本项目旨在德国开发并实施这样一套课程。
课程开发过程采用了基于同行的五步方法，包括小组测试以及用于试点实施阶段的课程“测试版”。CanMEDS框架作为德国全科医疗培训新的基于能力课程的基础。对来自欧洲国家和加拿大的四门课程进行了审查，并在进行必要的文化调整后，融入了这些课程的关键优势。对于课程的CanMEDS“医学专业知识”要素，还融入了世界家庭医生组织国际基层医疗分类法（WONCA ICPC - 2）中患者“就诊原因”的分类。
共有37名参与者参与了开发过程，他们代表德国12个不同的联邦州，还包括一名来自丹麦的专家顾问。建立了一个由医学专业知识、附加能力和医疗程序三部分组成的课程官方“测试版”。课程中采用交通信号灯量表为学员建立了自我评估系统。自2012年3月起，该课程的“测试版”已在网上免费提供。计划在2014年利用测试模型用户的反馈进行评估，作为实施过程的进一步阶段。
德国首个基于能力的全科医疗培训课程已采用务实的同行控制方法开发出来，并且正在通过课程的“测试版”进行试行。这个示范项目及其基于同行的方法可能会支持德国国内外其他医学专业基于能力的课程开发。
