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一种用于外科大查房的基于CanMEDS胜任力的反馈工具的开发与早期试用

Development and Early Piloting of a CanMEDS Competency-Based Feedback Tool for Surgical Grand Rounds.

作者信息

Fahim Christine, Bhandari Mohit, Yang Ilun, Sonnadara Ranil

机构信息

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Surg Educ. 2016 May-Jun;73(3):409-15. doi: 10.1016/j.jsurg.2015.12.003. Epub 2016 Feb 16.

Abstract

OBJECTIVE

Grand rounds offer an excellent opportunity for the evaluation of medical expertise, and other competencies, such as communication and professionalism. The purpose of this study was to develop a tool that would facilitate the provision of formative feedback for grand rounds to improve learning. The resulting CanMEDS-based evaluation tool was piloted in an academic surgical department.

DESIGN

This study employed the use of a 3-phase, qualitatively-focused, embedded mixed methods approach. In Phase 1, an intrinsic case study was conducted to identify preliminary themes. These findings were crystallized using a quantitative survey. Following interpretation of these data, a grand rounds evaluation tool was developed in Phase 2. The tool was piloted in the Phase 3 focus group.

SETTING

This study was piloted at an academic surgical center among members of the Department of Surgery, McMaster University, Ontario, Canada.

PARTICIPANTS

Purposive sampling was used for this study. A total of n = 7 individuals participated in the Phase 1 interviews, and n = 24 participants completed the Phase 1 survey. Participants included a representative sample of medical students, residents, fellows, and staff. The tool was piloted among n = 19 participants.

RESULTS

The proposed evaluation tool contains 13 Likert-scale questions and 2 open-ended questions. The tool outlines specific questions to assess grand rounds presenters within the structure of the 7 CanMEDS competency domains. "Evaluation fatigue" was identified as a major barrier in the willingness to provide effective feedback. Further, a number of factors regarding the preferred content, structure, and format of surgical grand rounds were identified.

CONCLUSIONS

This pilot study presents a CanMEDS-specific evaluation tool that can be applied to surgical grand rounds. With the increasing adoption of competency-based medical education, comprehensive evaluation of surgical activities is required. This form provides a template for the development of competency-based evaluation tools for medical and surgical learning activities.

摘要

目的

临床教学查房为评估医学专业知识以及沟通和职业素养等其他能力提供了绝佳机会。本研究的目的是开发一种工具,以便为临床教学查房提供形成性反馈,从而促进学习。由此产生的基于CanMEDS的评估工具在一个学术性外科科室进行了试点。

设计

本研究采用了一种分三个阶段、以定性研究为主、嵌入式混合方法的研究方法。在第一阶段,进行了一项内在案例研究以确定初步主题。这些发现通过定量调查得以明确。在对这些数据进行解读之后,第二阶段开发了一个临床教学查房评估工具。该工具在第三阶段的焦点小组中进行了试点。

背景

本研究在加拿大安大略省麦克马斯特大学外科系的一个学术性外科中心进行了试点。

参与者

本研究采用了目的抽样法。共有n = 7名个体参与了第一阶段的访谈,n = 24名参与者完成了第一阶段的调查。参与者包括医学生、住院医师、专科住院医师和工作人员的代表性样本。该工具在n = 19名参与者中进行了试点。

结果

拟议的评估工具包含13个李克特量表问题和2个开放式问题。该工具在7个CanMEDS能力领域的框架内概述了评估临床教学查房展示者的具体问题。“评估疲劳”被确定为提供有效反馈意愿的一个主要障碍。此外,还确定了一些关于外科临床教学查房的首选内容、结构和形式的因素。

结论

这项试点研究提出了一种可应用于外科临床教学查房的特定于CanMEDS的评估工具。随着基于能力的医学教育的日益普及,对外科活动进行全面评估是必要的。这种形式为开发用于医学和外科学习活动的基于能力的评估工具提供了一个模板。

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