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教职员工与住院医师“共同学习”:质量改进中教职员工发展创新模式的纵向探索

Faculty-Resident "Co-learning": A Longitudinal Exploration of an Innovative Model for Faculty Development in Quality Improvement.

作者信息

Wong Brian M, Goldman Joanne, Goguen Jeannette M, Base Christian, Rotteau Leahora, Van Melle Elaine, Kuper Ayelet, Shojania Kaveh G

机构信息

B. Wong is associate professor, Department of Medicine, and associate director, Centre for Quality Improvement and Patient Safety, both at the University of Toronto, Toronto, Ontario, Canada. He is also staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.J. Goldman is research education lead, Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada.J. Goguen is associate professor, Department of Medicine, and director, Internal Medicine Program, both at the University of Toronto, Toronto, Ontario, Canada. She is also staff physician, Division of Endocrinology, St. Michael's Hospital, Toronto, Ontario, Canada.C. Base is administrative assistant and program administrator, Co-Learning Quality Improvement Curriculum, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.L. Rotteau is program manager, Centre for Quality Improvement and Patient Safety, and doctoral candidate, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.E. Van Melle is senior education scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.A. Kuper is associate professor, Department of Medicine, and scientist, Wilson Centre for Research in Education, University Health Network, both at the University of Toronto, Toronto, Ontario, Canada. She is also staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.K. Shojania is professor, Department of Medicine, and director, Centre for Quality Improvement and Patient Safety, both at the University of Toronto, Toronto, Ontario, Canada. He is also staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

出版信息

Acad Med. 2017 Aug;92(8):1151-1159. doi: 10.1097/ACM.0000000000001505.

Abstract

PURPOSE

To examine the effectiveness of co-learning, wherein faculty and trainees learn together, as a novel approach for building quality improvement (QI) faculty capacity.

METHOD

From July 2012 through September 2015, the authors conducted 30 semistructured interviews with 23 faculty participants from the Co-Learning QI Curriculum of the Department of Medicine, Faculty of Medicine, University of Toronto, and collected descriptive data on faculty participation and resident evaluations of teaching effectiveness. Interviewees were from 13 subspecialty residency programs at their institution.

RESULTS

Of the 56 faculty participants, the Co-Learning QI Curriculum trained 29 faculty mentors, 14 of whom taught formally. Faculty leads with an academic QI role, many of whom had prior QI training, reinforced their QI knowledge while also developing QI mentorship and teaching skills. Co-learning elements that contributed to QI teaching skills development included seeing first how the QI content is taught, learning through project mentorship, building experience longitudinally over time, a graded transition toward independent teaching, and a supportive program lead. Faculty with limited QI experience reported improved QI knowledge, skills, and project facilitation but were ambivalent about assuming a teacher role. Unplanned outcomes for both groups included QI teaching outside of the curriculum, applying QI principles to other work, networking, and strengthening one's QI professional role.

CONCLUSIONS

The Co-Learning QI Curriculum was effective in improving faculty QI knowledge and skills and increased faculty capacity to teach and mentor QI. Findings suggest that a combination of curriculum and contextual factors were critical to realizing the curriculum's full potential.

摘要

目的

探讨共同学习(即教员和学员一起学习)作为一种培养质量改进(QI)教员能力的新方法的有效性。

方法

2012年7月至2015年9月,作者对多伦多大学医学院医学系共同学习QI课程的23名教员参与者进行了30次半结构化访谈,并收集了教员参与情况以及住院医师对教学效果评价的描述性数据。受访者来自该机构的13个专科住院医师培训项目。

结果

在56名教员参与者中,共同学习QI课程培训了29名教员导师,其中14名进行正式教学。担任学术QI角色的教员带头人,其中许多人之前接受过QI培训,在强化其QI知识的同时,还培养了QI指导和教学技能。有助于QI教学技能发展的共同学习要素包括:首先了解QI内容的教学方式、通过项目指导进行学习、随着时间纵向积累经验、逐步过渡到独立教学以及有支持性的项目负责人。QI经验有限的教员报告称,他们的QI知识、技能和项目推进能力有所提高,但对于承担教师角色持矛盾态度。两组的意外收获包括课程之外的QI教学、将QI原则应用于其他工作、建立人际关系网以及强化个人的QI专业角色。

结论

共同学习QI课程在提高教员的QI知识和技能以及增强教员教授和指导QI的能力方面是有效的。研究结果表明,课程因素和背景因素相结合对于充分发挥课程的潜力至关重要。

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