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划勾与奥运跳高——医生对国家医师认证体系的看法和认可。

Box-ticking and Olympic high jumping - Physicians' perceptions and acceptance of national physician validation systems.

机构信息

a Department of Educational Development and Research , School of Health Professions Education, Maastricht University , Maastricht , The Netherlands.

b Department of Education , European Respiratory Society , Lausanne , Switzerland.

出版信息

Med Teach. 2018 Sep;40(9):886-891. doi: 10.1080/0142159X.2018.1470320. Epub 2018 May 24.

Abstract

PURPOSE

National physician validation systems aim to ensure lifelong learning through periodic appraisals of physicians' competence. Their effectiveness is determined by physicians' acceptance of and commitment to the system. This study, therefore, sought to explore physicians' perceptions and self-reported acceptance of validation across three different physician validation systems in Europe.

MATERIALS AND METHODS

Using a constructivist grounded-theory approach, we conducted semi-structured interviews with 32 respiratory specialists from three countries with markedly different validation systems: Germany, which has a mandatory, credit-based system oriented to continuing professional development; Denmark, with mandatory annual dialogs and ensuing, non-compulsory activities; and the UK, with a mandatory, portfolio-based revalidation system. We analyzed interview data with a view to identifying factors influencing physicians' perceptions and acceptance.

RESULTS

Factors that influenced acceptance were the assessment's authenticity and alignment of its requirements with clinical practice, physicians' beliefs about learning, perceived autonomy, and organizational support.

CONCLUSIONS

Users' acceptance levels determine any system's effectiveness. To support lifelong learning effectively, national physician validation systems must be carefully designed and integrated into daily practice. Involving physicians in their design may render systems more authentic and improve alignment between individual ambitions and the systems' goals, thereby promoting acceptance.

摘要

目的

国家医师验证系统旨在通过对医师能力的定期评估来确保终身学习。其有效性取决于医师对该系统的接受程度和承诺程度。因此,本研究旨在探讨欧洲三个不同医师验证系统中医生对验证的看法和自我报告的接受程度。

材料与方法

我们采用建构主义扎根理论方法,对来自三个国家的 32 名呼吸专家进行了半结构化访谈,这些国家的验证系统有很大差异:德国采用强制性的、以继续职业发展为导向的基于学分的系统;丹麦采用强制性的年度对话和随之而来的非强制性活动;英国则采用强制性的基于档案袋的再验证系统。我们分析了访谈数据,以确定影响医生看法和接受程度的因素。

结果

影响接受程度的因素是评估的真实性和其要求与临床实践的一致性、医生对学习的信念、感知自主性和组织支持。

结论

用户的接受程度决定了任何系统的有效性。为了有效地支持终身学习,国家医师验证系统必须精心设计并融入日常实践。让医生参与设计可以使系统更加真实,并使个人目标与系统目标之间更加协调一致,从而提高接受程度。

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