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医学领域初级医生的导师指导与培训成果之间的关联:一项观察性研究。

The association between mentoring and training outcomes in junior doctors in medicine: an observational study.

作者信息

Ong John, Swift Carla, Magill Nicholas, Ong Sharon, Day Anne, Al-Naeeb Yasseen, Shankar Arun

机构信息

Department of Gastroenterology, Bedford Hospital, Bedford, UK.

Department of Gastroenterology, Addenbrooke's Cambridge University Hospital, Cambridge, UK.

出版信息

BMJ Open. 2018 Sep 21;8(9):e020721. doi: 10.1136/bmjopen-2017-020721.

Abstract

OBJECTIVE

To determine quantitatively if a positive association exists between the mentoring of junior doctors and better training outcomes in postgraduate medical training within the UK.

DESIGN

Observational study.

PARTICIPANTS

117 trainees from the East of England Deanery (non-mentored group) and the recently established Royal College of Physicians (RCP) Mentoring scheme (mentored group) who were core medical trainees (CMTs) between 2015 and 2017 completed an online survey. Trainees who received mentoring at the start of higher specialty training, incomplete responses and trainees who were a part of both the East of England deanery and RCP Mentoring scheme were excluded leaving 85 trainees in the non-mentored arm and 25 trainees in the mentored arm. Responses from a total of 110 trainees were analysed.

MAIN OUTCOME MEASURES

Pass rates of the various components of the Membership of the Royal College of Physicians (MRCP) (UK) examination (MRCP Part 1, MRCP Part 2 Written and MRCP Part 2 PACES), pass rates at the Annual Review of Competency Progression (ARCP), trainee involvement in significant events, clinical incidents or complaints and trainee feedback on career progression and confidence.

RESULTS

Mentored trainees reported higher pass rates of the MRCP Part 1 exam versus non-mentored trainees (84.0% vs 42.4%, p<0.01). Mentored international medical graduates (IMGs) reported higher pass rates than non-mentored IMGs in the MRCP Part 2 Written exam (71.4% vs 24.0%, p<0.05). ARCP pass rates in mentored trainees were observed to be higher than non-mentored trainees (95.8% vs 69.9%, p<0.05). Rates of involvement in significant events, clinical incidents and complaints in both groups did not show any statistical difference. Mentored trainees reported higher confidence and career progression.

CONCLUSIONS

A positive association is observed between the mentoring of CMTs and better training outcomes. Further studies are needed to investigate the causative effects of mentoring in postgraduate medical training within the UK.

摘要

目的

定量确定英国研究生医学培训中初级医生的导师指导与更好的培训结果之间是否存在正相关。

设计

观察性研究。

参与者

来自英格兰东部地区培训部(非导师指导组)和最近设立的皇家内科医师学院(RCP)导师指导计划(导师指导组)的117名学员,他们是2015年至2017年期间的核心医学实习生(CMT),完成了一项在线调查。在更高专科培训开始时接受导师指导的学员、回答不完整的学员以及同时属于英格兰东部地区培训部和RCP导师指导计划的学员被排除在外,最终非导师指导组有85名学员,导师指导组有25名学员。对总共110名学员的回答进行了分析。

主要观察指标

皇家内科医师学院(英国)会员资格考试(MRCP)各个部分(MRCP第1部分、MRCP第2部分笔试和MRCP第2部分实践技能评估)的通过率、能力进展年度评估(ARCP)的通过率、学员参与重大事件、临床事件或投诉的情况以及学员对职业发展和信心的反馈。

结果

接受导师指导的学员报告的MRCP第1部分考试通过率高于未接受导师指导的学员(84.0%对42.4%,p<0.01)。在MRCP第2部分笔试中,接受导师指导的国际医学毕业生(IMG)报告的通过率高于未接受导师指导的IMG(71.4%对24.0%,p<0.05)。观察到接受导师指导的学员的ARCP通过率高于未接受导师指导的学员(95.8%对69.9%,p<0.05)。两组参与重大事件、临床事件和投诉的发生率没有显示出任何统计学差异。接受导师指导的学员报告有更高的信心和职业发展。

结论

观察到CMT的导师指导与更好的培训结果之间存在正相关。需要进一步研究来调查英国研究生医学培训中导师指导的因果效应。

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