Neal Ashley E, Lehto Elizabeth, Miller Karen Hughes, Ziegler Craig, Davis Erin
Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Graduate Medical Education, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Congenit Heart Dis. 2018 Jan;13(1):147-153. doi: 10.1111/chd.12559. Epub 2017 Nov 27.
Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify "most important" content within these objectives.
DESIGN, METHODS, OUTCOME MEASURES: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives. We collected quantitative data (numerical indications of importance) and qualitative data (open-ended replies regarding missing content and difficulty in teaching and learning). Respondents indicated the top two choices of most important items within eight content areas. Descriptive statistics (frequencies and percentages) and chi-square analysis were calculated. Content within categories was organized using naturally occurring "clusters" and "gaps" in scores. Common themes among open-ended qualitative responses were identified using Pandit's version of Glaser and Strauss Grounded theory (constant comparison).
Of the 136 respondents, 23 (17%) were residents, 15 (11%) fellows, 85 (62%) pediatricians, and 13 (10%) pediatric cardiologists. Of attendings, 80% reported faculty/gratis faculty status. Naturally occurring clusters in respondent-designated importance resulted in ≤3 "most selected" objectives per content area. Objectives in "most selected" content pertained to initial diagnosis (recognition of abnormality/disease) (n = 16), possible emergent/urgent intervention required (n = 14), building a differential (n = 8), and planning a workup (n = 4). Conversely, themes for "least selected" content included comanagement with subspecialist (n = 15), knowledge useful in patient-family communication (n = 9), knowledge that can be referenced (as needed) (n = 7), and longitudinal/follow-up concerns (n = 5).
This study demonstrated the utility of an online survey methodology to identify pediatric cardiology content perceived most important. Learners and faculty generally provided concordant responses regarding most important content within the cardiology-specific ABP objectives. Medical educators could apply this methodology to inform curriculum revision.
虽然已对儿科医生报告的加拿大心脏病学特定目标的相关性进行了研究，但关于2016年美国儿科学会（ABP）心脏病学特定目标的类似数据尚不可得。本研究要求肯塔基州的实习医生、儿科医生和儿科心脏病专家确定这些目标中“最重要”的内容。
设计、方法、结果测量：这项横断面研究使用了基于2016年ABP心脏病学特定目标的原创在线调查问卷。我们收集了定量数据（重要性的数值指标）和定性数据（关于缺失内容以及教学和学习困难的开放式回答）。受访者指出了八个内容领域中最重要项目的前两个选择。计算了描述性统计数据（频率和百分比）以及卡方分析。类别内的内容使用分数中自然出现的“聚类”和“空白”进行组织。使用潘迪特版的格拉斯和施特劳斯扎根理论（持续比较）确定开放式定性回答中的共同主题。
在136名受访者中，23名（17%）是住院医生，15名（11%）是研究员，85名（62%）是儿科医生，13名（10%）是儿科心脏病专家。在主治医师中，80%报告具有教职员工/免费教职员工身份。受访者指定的重要性中自然出现的聚类导致每个内容领域≤3个“最常被选择”的目标。“最常被选择”内容中的目标涉及初始诊断（异常/疾病的识别）（n = 16）、可能需要的紧急/急诊干预（n = 14）、建立鉴别诊断（n = 8）以及制定检查计划（n = （此处原文有误，根据前文推测应为4）4）。相反，“最不常被选择”内容的主题包括与专科医生共同管理（n = 15）、对患者 - 家属沟通有用的知识（n = 9）、可（按需）参考的知识（n = 7）以及纵向/随访问题（n = 5）。
本研究证明了在线调查方法在确定被认为最重要的儿科心脏病学内容方面的实用性。学习者和教员对于ABP心脏病学特定目标中最重要的内容通常给出了一致的回答。医学教育工作者可以应用这种方法为课程修订提供参考。
