University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
University of Pittsburgh, Pittsburgh, PA, USA.
J Gen Intern Med. 2017 Nov;32(11):1255-1260. doi: 10.1007/s11606-017-4089-8. Epub 2017 Jun 20.
The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies. The authors propose a curricular framework based on five CEPAERs that were felt to be most relevant to residency preparation, informed by prior stakeholder surveys. The critical areas outlined include entering orders, forming and answering clinical questions, conducting patient care handovers, collaborating interprofessionally, and recognizing patients requiring urgent care and initiating that care. For each CEPAER, the authors offer suggestions about instruction and assessment of competency. The fourth year of medical school can be rewarding for students, while adequately preparing them to begin residency, by addressing important elements defined in the core entrustable activities. Thus prepared, new residents can function safely and competently in supervised postgraduate settings.
医学院四年级的教学目标仍然存在争议。在这个过渡阶段，学生和教育工作者面临着相互竞争的要求，感到困惑。2014 年，美国医学院协会（AAMC）发布了 13 项进入住院医师实习阶段的可委托的核心专业活动（CEPAERs）。一个由内科住院医师指导主任协会和内科住院医师项目主任协会成员组成的委员会，将这些原则应用于为内科住院医师实习做准备。作者根据先前利益相关者的调查，提出了一个基于 5 项最相关的住院医师准备的 CEPAER 的课程框架。概述的关键领域包括下达医嘱、形成和回答临床问题、进行患者护理交接、跨专业合作以及识别需要紧急护理的患者并启动护理。对于每个 CEPAER，作者都提出了关于教学和能力评估的建议。通过解决核心委托活动中定义的重要内容，医学院四年级可以让学生有收获，同时为他们开始住院医师实习做好充分准备。有了这些准备，新的住院医师可以在监督下的研究生环境中安全、胜任地工作。
