预后：加拿大医师能力基准（CanMEDS）胜任力框架中的“缺失环节”。

Prognosis: the "missing link" within the CanMEDS competency framework.

机构信息

University of Toronto, 101 Humber College Boulevard, 9th Floor, Toronto, Ontario M9V 1R8, Canada.

出版信息

BMC Med Educ. 2014 May 13;14:93. doi: 10.1186/1472-6920-14-93.

DOI:10.1186/1472-6920-14-93

PMID:24886446

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4026055/

Abstract

BACKGROUND

The concept of prognosis dates back to antiquity. Quantum advances in diagnostics and therapeutics have relegated this once highly valued core competency to an almost negligible role in modern medical practice. Medical curricula are devoid of teaching opportunities focused on prognosis. This void is driven by a corresponding relative dearth within physician competency frameworks. This study aims to assess the level of content related to prognosis within CanMEDS (Canadian Medical Education Directives for Specialists), a leading and prototypical physician competency framework.

METHODS

A quantitative content analysis of CanMEDS competency framework was carried out to measure the extent of this deficiency. Foxit Reader 5.1 (Foxit Corporation), a keyword scanning software, was used to assess the CanMEDS 2005 framework documents of 29 physician specialties and 37 subspecialties across the seven physician roles (medical expert, communicator, collaborator, manager, health advocate, scholar, and professional). The keywords used in the search included prognosis, prognostic, prognosticate, and prognostication.

RESULTS

Of the 29 specialties six (20.7%) contained at least one citation of the keyword "prognosis", and one (3.4%) contained one citation of the keyword "prognostic". Of the 37 subspecialties, sixteen (43.2%) contained at least one citation of the keyword "prognosis", and three (8.1%) contained at least one citation of the keyword "prognostic". The terms "prognosticate" and "prognostication" were completely absent from all CanMEDS 2005 documents. Overall, the combined citations for "prognosis" and "prognostic" were linked with the following competency roles: Medical Expert (80.3%), Scholar (11.5%), and Communicator (8.2%).

CONCLUSIONS

Given the fundamental and foundational importance of prognosis within medical practice, it is recommended that physicians develop appropriate attitudes, skills and knowledge related to the formulation and communication of prognosis. The deficiencies within CanMEDS, demonstrated by this study, should be addressed in advance of the launch of its updated version in 2015.

摘要

背景

预后的概念可以追溯到古代。诊断和治疗技术的量子进步使这一曾经备受重视的核心能力在现代医学实践中几乎变得微不足道。医学课程中没有专门针对预后的教学机会。这种空白是由医生能力框架中相应的相对缺乏所驱动的。这项研究旨在评估 CanMEDS（加拿大医学教育专家指令）中与预后相关的内容水平，CanMEDS 是一种领先的、典型的医生能力框架。

方法

对 CanMEDS 能力框架进行了定量内容分析，以衡量这种不足的程度。使用 Foxit Reader 5.1（Foxit 公司），一种关键词扫描软件，评估了七个医生角色（医学专家、沟通者、合作者、管理者、健康倡导者、学者和专业人员）中的 29 个医生专业和 37 个亚专业的 CanMEDS 2005 框架文件。搜索中使用的关键词包括预后、预后、预测和预测。

结果

在 29 个专业中，有 6 个（20.7%）至少引用了“预后”一词，有 1 个（3.4%）引用了“预后”一词。在 37 个亚专业中，有 16 个（43.2%）至少引用了“预后”一词，有 3 个（8.1%）至少引用了“预后”一词。术语“预测”和“预测”在所有 CanMEDS 2005 文档中完全不存在。总体而言，“预后”和“预后”的综合引用与以下能力角色相关：医学专家（80.3%）、学者（11.5%）和沟通者（8.2%）。