Rosenbluth Glenn, O'Brien Bridget, Asher Emily M, Cho Christine S
J Grad Med Educ. 2014 Mar;6(1):106-11. doi: 10.4300/JGME-D-13-00146.1.
Faculty in graduate medical education programs may not have uniform approaches to differentiating the quality of residents, and reviews of evaluations suggest that faculty use different standards when assessing residents. Standards for assessing residents also do not consistently map to items on evaluation forms. One way to improve assessment is to reach consensus on the traits and behaviors that are (or should be) present in the best residents.
A trained interviewer conducted semistructured interviews with faculty affiliated with 2 pediatrics residency programs until content saturation was achieved. Interviewees were asked to describe specific traits present in residents they identify as the best. Interviews were recorded and transcribed. We used an iterative, inductive approach to generate a coding scheme and identify common themes.
From 23 interviews, we identified 7 thematic categories of traits and behaviors: personality, energy, professionalism, team behaviors, self-improvement behaviors, patient-interaction behaviors, and medical knowledge and clinical skills (including a subcategory, knowledge integration). Most faculty interviewees focused on traits like passion, enthusiasm, maturity, and reliability. Examination score or intelligence was mentioned less frequently than traits and behaviors categorized under personality and professionalism.
Faculty identified many traits and behaviors in the residents they define as the best. The thematic categories had incomplete overlap with Accreditation Council for Graduate Medical Education (ACGME) and CanMEDS competencies. This research highlights the ongoing need to review our assessment strategies, and may have implications for the ACGME Milestone Project.
研究生医学教育项目中的教员在区分住院医师质量方面可能没有统一的方法，对评估的审查表明，教员在评估住院医师时使用不同的标准。评估住院医师的标准也没有始终如一地映射到评估表上的项目。改进评估的一种方法是就优秀住院医师所具备（或应该具备）的特质和行为达成共识。
一名经过培训的访谈者对隶属于两个儿科住院医师项目的教员进行了半结构化访谈，直至达到内容饱和。受访者被要求描述他们认为是最优秀的住院医师所具有的具体特质。访谈进行了录音和转录。我们采用迭代归纳法生成编码方案并确定共同主题。
通过23次访谈，我们确定了特质和行为的7个主题类别：个性、活力、专业精神、团队行为、自我提升行为、医患互动行为以及医学知识和临床技能（包括一个子类别，知识整合）。大多数教员受访者关注的特质包括热情、积极性、成熟度和可靠性。与个性和专业精神类别下的特质和行为相比，考试成绩或智力被提及的频率较低。
教员们确定了他们认为最优秀的住院医师所具有的许多特质和行为。这些主题类别与研究生医学教育认证委员会（ACGME）和加拿大医学教育专业认证委员会（CanMEDS）的能力要求存在不完全重叠。本研究强调了持续审查我们评估策略的必要性，可能对ACGME里程碑项目产生影响。
