使用临床实习和住院医师培训准备情况调查来评估四个医学博士项目的有效性：一项跨机构可推广性研究。

Using the Readiness for Clerkship and Residency Surveys to Evaluate the Effectiveness of Four MD Programs: A Cross-Institutional Generalizability Study.

作者信息

Peterson Linda N, Rusticus Shayna A, Eva Kevin W, Wilson Derek A, Pittini Richard J, Schreiber Martin, Pinchin Sheila E, Moffatt Susan L, Sargeant Joan M, Warren Andrew E, Alexiadis-Brown Peggy

机构信息

L.N. Peterson is former senior evaluation advisor, Evaluation Studies Unit, Medical Education, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and former assistant secretary, Committee on the Accreditation of Canadian Medical Schools, Association of Faculties of Medicine of Canada, Ottawa, Ontario, Canada. S.A. Rusticus is instructor, Department of Psychology, Kwantlen Polytechnic University, Surrey, British Columbia, Canada, and former statistical analyst, Evaluation Studies Unit, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. K.W. Eva is professor and director, Education Research and Scholarship, Department of Medicine, and associate director and senior scientist, Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500. D.A. Wilson is director, Evaluation Studies Unit, Medical Education, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. R.J. Pittini is associate professor, Department of Obstetrics and Gynecology, and director, Evaluations of the MD Program, University of Toronto, Toronto, Ontario, Canada. M. Schreiber is professor, Department of Medicine, and 3M National Teaching Fellow. He is former director, Undergraduate Medical Education Curriculum, and interim accreditation review coordinator, University of Toronto, Toronto, Ontario, Canada. S.E. Pinchin is educational specialist and manager, Division of Undergraduate Medical Educational Support and Development, Queens University, Kingston, Ontario, Canada. S.L. Moffatt is associate professor, Department of Medicine, and director, Clerkship Curricular Courses, Queens University, Kingston, Ontario, Canada. J.M. Sargeant is professor, Division of Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. A.E. Warren is associate professor, Department of Pediatrics, and associate dean, Postgraduate Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada. P. Alexiadis-Brown is program evaluation specialist, Dalhousie Medicine New Brunswick Program, and instructor, School of Health Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Acad Med. 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S100-S109. doi: 10.1097/ACM.0000000000001926.

DOI:10.1097/ACM.0000000000001926

PMID:29065030

Abstract

PURPOSE

The importance of confidence for learning and performance makes learners' perceptions of readiness for the next level of training valuable indicators of curricular success. The "Readiness for Clerkship" (RfC) and "Readiness for Residency" (RfR) surveys have been shown to provide reliable ratings of the relative effectiveness of various aspects of training. This study examines the generalizability of those results.

METHOD

Surveys were administered at four medical schools approximately four months after the start of clerkship and eight months after the start of residency during 2013-2015. Collected data were anonymized. A total of 647 medical students and 483 residents participated.

RESULTS

Reliabilities of G = 0.8 could be obtained with only 6 to 12 medical students and 8 to 15 residents. Within MD programs, no meaningful differences in item ratings were observed across cohorts. Residents in each school consistently rated themselves higher than clerks on the majority of Medical Expert and Communicator competencies common to both surveys. Similar strengths and weaknesses were identified across programs, but differences were observed on five clerkship items and one residency item.

CONCLUSIONS

Across four MD programs, the RfC and RfR surveys provided reliable ratings of the relative effectiveness of aspects of training with small numbers of respondents. The capacity of these surveys to efficiently identify perceived strengths and weaknesses held by cohorts of learners may, thereby, facilitate program improvement.

摘要

目的

自信对于学习和表现至关重要，这使得学习者对进入下一阶段培训的准备程度认知成为课程成功的重要指标。“实习准备度”（RfC）和“住院医师培训准备度”（RfR）调查已被证明能对培训各方面的相对有效性提供可靠评分。本研究探讨这些结果的可推广性。

方法

在2013 - 2015年期间，在四所医学院校实习开始约四个月后以及住院医师培训开始八个月后进行调查。收集的数据进行了匿名处理。共有647名医学生和483名住院医师参与。

结果

仅6至12名医学生和8至15名住院医师就能获得G = 0.8的信度。在医学博士项目中，各队列在项目评分上未观察到有意义的差异。在两项调查共有的大多数医学专家和沟通者能力方面，各学校的住院医师始终给自己的评分高于实习医师。不同项目中发现了相似的优势和劣势，但在五项实习项目和一项住院医师培训项目上存在差异。