Department of Emergency Medicine, Johns Hopkins University School of Medicine, , Baltimore, Maryland, USA.
Postgrad Med J. 2014 Jan;90(1059):3-7. doi: 10.1136/postgradmedj-2012-131714. Epub 2013 Aug 20.
Experts have proposed core curriculum components for international emergency medicine (IEM) fellowships. This study examined perceptions of program directors (PDs) and fellows on whether IEM fellowships cover these components, whether their perspectives differ and the barriers preventing fellowships from covering them.
From 1 November 2011 to 30 November 2011, a survey was administered to PDs, current fellows and recent graduates of the 34 US IEM fellowships. Respondents quantified their fellowship experience in six proposed core curriculum areas: emergency medicine (EM) systems development, EM education, humanitarian assistance, public health, emergency medical services and disaster medicine. Analysis was performed regarding what per cent of programmes fulfil the six curriculum areas. A paired t test determined the difference between PDs' and fellows' responses. Agreement between PDs and fellows within the same programme was determined using a κ statistic.
Only 1/18 (6%) (according to fellows) to 2/24 (8%) (according to PDs) of programmes expose fellows to all six components. PDs consistently reported higher exposure than fellows. The difference in mean score between PDs and fellows was statistically significant (p<0.05) in three of the 6 (50%) core curriculum elements: humanitarian aid, public health and disaster medicine. Per cent agreement between PDs and fellows within each programmes ranged from poor to fair.
While IEM fellowships have varying structure, this study highlights the importance of further discussion between PDs and fellows regarding delineation and objectives of core curriculum components. Transparent curricula and open communication between PDs and fellows may reduce differences in reported experiences.
专家们为国际急诊医学（IEM）研究员提出了核心课程内容。本研究考察了项目主任（PDs）和研究员对以下问题的看法：IEM 研究员是否涵盖这些内容，他们的观点是否存在差异，以及哪些障碍阻止了研究员涵盖这些内容。
从 2011 年 11 月 1 日至 30 日，对 34 个美国 IEM 研究员的 PDs、现任研究员和最近的毕业生进行了调查。受访者在六个拟议的核心课程领域量化了他们的研究员经验：急诊医学（EM）系统开发、EM 教育、人道主义援助、公共卫生、急救医疗服务和灾害医学。分析了哪些方案满足了这六个课程领域。配对 t 检验确定了 PDs 和研究员之间的反应差异。通过κ统计量确定同一方案中 PDs 和研究员之间的一致性。
只有 1/18（6%）（根据研究员）到 2/24（8%）（根据 PDs）的方案使研究员接触到所有六个部分。PDs 报告的暴露率始终高于研究员。PDs 和研究员之间的平均分数差异在六个核心课程要素中的三个（50%）中具有统计学意义（p<0.05）：人道主义援助、公共卫生和灾害医学。每个方案中 PDs 和研究员之间的百分比一致性从差到一般不等。
虽然 IEM 研究员有不同的结构，但本研究强调了 PDs 和研究员之间进一步讨论核心课程内容的划分和目标的重要性。透明的课程和 PDs 与研究员之间的开放沟通可能会减少报告经验的差异。
