Dr. Lowry is assistant professor, Department of Internal Medicine, and associate program director for compliance and programming, Internal Medicine Residency Program, University of Kansas Medical Center, Kansas City, Kansas. Dr. Vansaghi is associate professor, Department of Internal Medicine, and program director, Internal Medicine Residency Program, University of Kansas Medical Center, Kansas City, Kansas. Dr. Rigler is professor, Department of Internal Medicine, and director, Office of Scholarly, Academic and Research Mentoring, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas. Dr. Stites is Peter T. Bohan Professor and Chair, Department of Internal Medicine, University of Kansas School of Medicine, and senior associate dean for clinical affairs, University of Kansas Medical Center, Kansas City, Kansas.
Acad Med. 2013 Nov;88(11):1665-9. doi: 10.1097/ACM.0b013e3182a8c756.
In 2010, University of Kansas Medical Center internal medicine residency program leaders concluded that their competency-based curriculum and evaluation system was not sufficient to promote accurate assessment of learners' performance and needed revision to meet the requirements of the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS). Evaluations of learners seldom referenced existing curricular goals and objectives and reflected an "everyone is exceptional, no one is satisfactory" view.The authors identified the American Board of Internal Medicine and ACGME's Developmental Milestones for Internal Medicine Residency Training as a published standard for resident development. They incorporated the milestones into templates, a format that could be modified for individual rotations. A milestones-based curriculum for each postgraduate year of training and every rotation was then created, with input from educational leaders within each division in the Department of Internal Medicine and with the support of the graduate medical education office.In this article, the authors share their implementation process, which took approximately one year, and discuss their current work to create a documentation system for direct observation of entrustable professional activities, with the aim of providing guidance to other programs challenged with developing an outcomes-based curriculum and assessment system within the time frame of the NAS.
2010 年，堪萨斯大学医学中心内科住院医师培训计划的负责人得出结论，他们的基于能力的课程和评估系统不足以促进对学习者表现的准确评估，需要进行修订以满足研究生医学教育认证委员会（ACGME）下一认证系统（NAS）的要求。对学习者的评估很少参考现有的课程目标，反映了一种“每个人都是杰出的，没有人是满意的”的观点。作者将美国内科委员会和内科住院医师培训的 ACGME 发展里程碑确定为居民发展的既定标准。他们将这些里程碑纳入模板中，这是一种可以为每个轮转修改的格式。然后为每个研究生培训年和每个轮转创建了基于里程碑的课程，这是在内科部门内的每个教育领导的参与下，并得到了研究生医学教育办公室的支持。在本文中，作者分享了他们大约需要一年时间的实施过程，并讨论了他们目前创建直接观察可委托专业活动文档系统的工作，旨在为其他面临在 NAS 时间框架内开发基于成果的课程和评估系统的项目提供指导。
