Kellam James F, Archibald Douglas, Barber James W, Christian Eugene P, D'Ascoli Richard J, Haynes Richard J, Hecht Suzanne S, Hurwitz Shepard R, Kellam James F, McLaren Alexander C, Peabody Terrance D, Southworth Stephen R, Strauss Robert W, Wadey Veronica M R
1University of Texas Health Science Center at Houston, Houston, Texas.
J Bone Joint Surg Am. 2017 Jan 18;99(2):175-181. doi: 10.2106/JBJS.16.00761.
With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery.
Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery.
For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest.
These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice.
These competencies provide many stakeholders, including orthopaedic educators and orthopaedists, with what may be the minimum knowledge and competencies necessary to deliver acute and general orthopaedic care. This document is the first step in defining a practice-based standard for training programs and certification groups.
随着骨科手术护理方式的不断变化，有必要明确一名提供普通和/或急性骨科护理的骨科医生应具备的知识和能力。本文针对一名骨科医生开展普通和/或急性护理骨科手术所需的知识和能力提出了一项建议。
由与普通骨科实践相关的利益相关者组成的普通骨科能力特别工作组，采用改良德尔菲法，提出了从事急诊和普通骨科手术的骨科医生应具备的核心知识和能力。
为了与临床实践相关，确立了两组基本能力。评估能力涉及评估、调查和确定总体管理计划所需的一般知识。管理能力本质上一般是程序性的，分为两组。对于管理1组，骨科医生应能够提供确定性护理，包括评估、调查、初始或急诊护理、手术或非手术护理以及随访。对于管理2组，骨科医生应能够评估、调查并及时开始非紧急或紧急护理，然后根据护理的紧迫性、特殊的实践情况或个人的更高培训水平，将患者转至适当的专科医生处护理或提供确定性护理。这可能包括一些通常由专科医生进行的高级手术，但根据经验、实践环境和/或专业兴趣与个人的实践相符。
这些能力是界定包括急性骨科护理在内的普通骨科手术实践的第一步。教育工作者、普通骨科外科医生和专科医生之间的进一步验证和讨论将确保这些能力与临床实践相关。
这些能力为包括骨科教育工作者和骨科医生在内的许多利益相关者提供了提供急性和普通骨科护理可能所需的最低知识和能力。本文档是为培训项目和认证团体定义基于实践的标准的第一步。
