McEwen Laura A, Griffiths Jane, Schultz Karen
L.A. McEwen is director, Assessment and Evaluation, Postgraduate Medical Education, and assistant professor, Department of Pediatrics, Queen's University, Kingston, Ontario, Canada. J. Griffiths is assistant professor and assessment director, Department of Family Medicine, Queen's University, Kingston, Ontario, Canada. K. Schultz is associate professor and program director, Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Acad Med. 2015 Nov;90(11):1515-26. doi: 10.1097/ACM.0000000000000754.
The use of portfolios in postgraduate medical residency education to support competency development is increasing; however, the processes by which these assessment systems are designed, implemented, and maintained are emergent. The authors describe the needs assessment, development, implementation, and continuing quality improvement processes that have shaped the Portfolio Assessment Support System (PASS) used by the postgraduate family medicine program at Queen's University since 2009. Their description includes the impetus for change and contextual realities that guided the effort, plus the processes used for selecting assessment components and developing strategic supports. The authors discuss the identification of impact measures at the individual, programmatic, and institutional levels and the ways the department uses these to monitor how PASS supports competency development, scaffolds residents' self-regulated learning skills, and promotes professional identity formation. They describe the "academic advisor" role and provide an appendix covering the portfolio elements. Reflection elements include learning plans, clinical question logs, confidence surveys, and reflections about continuity of care and significant incidents. Learning module elements cover the required, online bioethics, global health, and consult-request modules. Assessment elements cover each resident's research project, clinical audits, presentations, objective structured clinical exam and simulated office oral exam results, field notes, entrustable professional activities, multisource feedback, and in-training evaluation reports. Document elements are the resident's continuing medical education activities including procedures log, attendance log, and patient demographic summaries.The authors wish to support others who are engaged in the systematic portfolio-design process or who may adapt aspects of PASS for their local programs.
在研究生医学住院医师培训教育中，使用档案袋来支持能力发展的情况日益增多；然而，这些评估系统的设计、实施和维护过程仍在不断涌现。作者描述了自2009年以来塑造女王大学研究生家庭医学项目所使用的档案袋评估支持系统（PASS）的需求评估、开发、实施和持续质量改进过程。他们的描述包括推动变革的因素和指导这项工作的背景实际情况，以及用于选择评估组件和制定战略支持措施的过程。作者讨论了在个人、项目和机构层面确定影响措施的情况，以及该部门如何利用这些措施来监测PASS如何支持能力发展、搭建住院医师自我调节学习技能的支架以及促进职业身份形成。他们描述了“学术顾问”的角色，并提供了一个涵盖档案袋要素的附录。反思要素包括学习计划、临床问题记录、信心调查以及关于医疗连续性和重大事件的反思。学习模块要素涵盖必修的在线生物伦理学、全球健康和咨询请求模块。评估要素涵盖每位住院医师的研究项目、临床审核、报告、客观结构化临床考试和模拟办公室口试结果、实地记录、可托付专业活动、多源反馈以及培训期间评估报告。文档要素是住院医师的继续医学教育活动，包括操作记录、出勤记录和患者人口统计学摘要。作者希望支持其他从事系统档案袋设计过程的人，或者那些可能会根据当地项目调整PASS某些方面的人。
