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可托付专业活动的操作技能:美国即将毕业的医学生是否准备好在住院医师阶段进行操作?

Procedural Skills of the Entrustable Professional Activities: Are Graduating US Medical Students Prepared to Perform Procedures in Residency?

作者信息

Bruce Adrienne N, Kumar Anagha, Malekzadeh Sonya

机构信息

Department of Student Research, Georgetown University School of Medicine, Washington, DC.

Department of Biostatistics, MedStar Health Research Institute, Hyattsville, Maryland.

出版信息

J Surg Educ. 2017 Jul-Aug;74(4):589-595. doi: 10.1016/j.jsurg.2017.01.002. Epub 2017 Jan 23.

Abstract

PURPOSE

Competency-based medical education has been successfully instituted in graduate medical education through the development of Milestones. Consequently, the Association of American Medical Colleges implemented the core entrustable professional activities initiative to complement this framework in undergraduate medical education. We sought to determine its efficacy by examining the experiences and confidence of recent medical school graduates with general procedural skills (entrustable professional activities 12).

METHOD

We administered an electronic survey to the MedStar Georgetown University Hospital intern class assessing their experiences with learning and evaluation as well as their confidence with procedural skills training during medical school. Simple linear regression was used to compare respondent confidence and the presence of formal evaluation in medical school.

RESULTS

We received 28 complete responses, resulting in a 33% response rate, whereas most respondents indicated that basic cardiopulmonary resuscitation, bag/mask ventilation, and universal precautions were important to and evaluated by their medical school, this emphasis was not present for venipuncture, intravenous catheter placement, and arterial puncture. Mean summed scores of confidence for each skill indicated a statistically significant effect between confidence and evaluation of universal precaution skills.

CONCLUSIONS

More advanced procedural skills are not considered as important for graduating medical students and are less likely to be taught and formally evaluated before graduation. Formal evaluation of some procedural skills is associated with increased confidence of the learner.

摘要

目的

通过制定“里程碑”,基于能力的医学教育已在毕业后医学教育中成功实施。因此,美国医学院协会实施了核心可托付专业活动倡议,以补充本科医学教育中的这一框架。我们试图通过考察近期医学院毕业生在一般程序技能(可托付专业活动12)方面的经历和信心来确定其效果。

方法

我们对MedStar乔治敦大学医院实习班进行了一项电子调查,评估他们在医学院期间的学习和评估经历以及对程序技能培训的信心。使用简单线性回归来比较受访者的信心与医学院正式评估的情况。

结果

我们收到了28份完整回复,回复率为33%。大多数受访者表示,基本心肺复苏、面罩通气和通用防护措施对他们的医学院来说很重要且会进行评估,但静脉穿刺、静脉导管置入和动脉穿刺则并非如此。每项技能的平均信心总分表明,通用防护技能的信心与评估之间存在统计学上的显著影响。

结论

更高级的程序技能对即将毕业的医学生来说不被视为重要技能,并且在毕业前不太可能被教授和进行正式评估。对某些程序技能的正式评估与学习者信心的提高相关。

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