Badesch D B, McClellan M D, Wheeler A P, Archer P G, Schwarz M I, Petty T L
Department of Medicine, University of Colorado Health Sciences Center, Denver 80262.
Am Rev Respir Dis. 1989 Oct;140(4):1136-42. doi: 10.1164/ajrccm/140.4.1136.
A model is presented for the objective assessment of clinical training programs. The model documents the clinical trainee's experience by the diagnoses seen and procedures performed during a full year of experience. It also surveys faculty impressions of the trainee's experience and their judgment of what is necessary to constitute an adequate experience. In the pilot study applying this model to two pulmonary medicine fellowship programs, several important observations were made: (1) faculty members may not have an accurate perception of the fellow's actual clinical experience, (2) faculty impressions of the fellow's experience often do not correspond to their own conception of an adequate clinical experience, (3) interprogram variability exists, (4) pulmonary fellows may have inadequate experience with certain invasive procedures. These observations suggest that wilder application of such a model could provide valuable information to program directors and subspecialty boards. In addition, directors of pulmonary disease training programs have been asked by the American Board of Internal Medicine to establish systems to evaluate, document, and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. The model presented here provides an accurate and efficient means for such evaluation and documentation.
本文提出了一种用于临床培训项目客观评估的模型。该模型通过记录临床实习生一整年的所见诊断和所实施的操作来记录其临床经验。它还调查了教员对实习生经验的印象以及他们对构成充分经验所需条件的判断。在将此模型应用于两个肺医学 fellowship 项目的初步研究中，得出了几个重要观察结果：（1）教员可能对研究员的实际临床经验没有准确的认知；（2）教员对研究员经验的印象往往与他们自己对充分临床经验的概念不相符；（3）项目间存在差异；（4）肺科研究员在某些侵入性操作方面可能经验不足。这些观察结果表明，更广泛地应用这样的模型可以为项目主任和亚专业委员会提供有价值的信息。此外，美国内科医学委员会要求肺病培训项目主任建立系统，以评估、记录和证实那些被认为是亚专业认证所必需的整体临床能力组成部分。这里提出的模型为这种评估和记录提供了一种准确而有效的方法。
