*Department of Emergency Medicine,University of Ottawa,Ottawa,ON.
CJEM. 2019 Mar;21(2):274-282. doi: 10.1017/cem.2018.374. Epub 2018 Jun 11.
Enhanced skills training in emergency medicine through the Canadian College of Family Physicians, CCFP(EM), has existed since the 1980s. Accreditation standards define what every program "must" and "should" have, yet little is known on what is currently done across Canada. Our objectives were to 1) describe major components of CCFP(EM) programs and 2) determine how curricular components are taught.
After a rigorous development process (expert content development, cognitive reviews, and pilot testing), a survey questionnaire was administered to all 17 CCFP(EM) program directors using a modified Dillman technique.
All (17/17) program directors responded. Programs are similar in core clinical rotations conducted and provide ultrasound courses for basic skills (trauma, abdominal aortic aneurysm, intrauterine pregnancy). Variation exists for offering independent ultrasound certification (77%), advanced scanning (18%), and protected time for scanning (53%). All programs utilize high fidelity simulation. Some programs use in situ simulation (18%) and carry out a simulation boot camp (41%). Most centres require an academic project, which is a quality assurance project (53%) and/or a critical appraisal of the literature (59%). Publication or national conference presentations are required by 12% of programs. Competency-based curricula include simulation for rare procedures (88%), direct observations (65%), and a "transition to practice" curriculum (24%). All programs maintain strong connections to family medicine.
This study demonstrates the diverse structures of CCFP(EM) programs across Canada. Programs have similar clinical rotations, ultrasound, and simulation requirements. Variation exists in administrative structure and financial resources of programs, academic project requirements, and programs' competency-based curricula.
自 20 世纪 80 年代以来,加拿大家庭医生学院(CCFP[EM])一直在进行急诊医学技能强化培训。认证标准定义了每个项目“必须”和“应该”具备的内容,但对于加拿大各地目前的情况却知之甚少。我们的目标是:1)描述 CCFP(EM)项目的主要组成部分;2)确定课程组成部分的教学方法。
经过严格的开发过程(专家内容开发、认知审查和试点测试),使用经过修改的 Dillman 技术向所有 17 名 CCFP(EM)项目主任发放了调查问卷调查表。
所有(17/17)项目主任都做出了回应。各项目在核心临床轮转方面相似,并提供基础技能(创伤、腹主动脉瘤、宫内妊娠)的超声课程。在提供独立的超声认证(77%)、高级扫描(18%)和扫描专用时间(53%)方面存在差异。所有项目均使用高保真模拟。一些项目使用现场模拟(18%)和开展模拟训练营(41%)。大多数中心都要求进行学术项目,其中 53%是质量保证项目,59%是文献批判性评估。12%的项目要求发表文章或在全国会议上进行演讲。基于能力的课程包括对罕见操作的模拟(88%)、直接观察(65%)和“过渡到实践”课程(24%)。所有项目都与家庭医学保持密切联系。
本研究展示了加拿大 CCFP(EM)项目的多样化结构。各项目具有相似的临床轮转、超声和模拟要求。在行政结构和项目财务资源、学术项目要求以及项目基于能力的课程方面存在差异。