K.S. Lundsgaard is a PhD student, University of Copenhagen, Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark; ORCID: https://orcid.org/0000-0002-6517-8497. M.G. Tolsgaard is associate professor, University of Copenhagen and Copenhagen Academy of Medical Education and Simulation, Capital Region, Denmark; ORCID: https://orcid.org/0000-0001-9197-5564. O.S. Mortensen is professor, Department of Public Health, Section of Social Medicine, University of Copenhagen, and Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark; ORCID: https://orcid.org/0000-0002-4655-8048. M. Mylopoulos is associate professor, Department of Paediatrics, scientist, MD Program, and associate director, Wilson Centre, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-0012-5375. D. Østergaard is director, Copenhagen Academy of Medical Education and Simulation, and professor, University of Copenhagen, Capital Region, Denmark; ORCID: https://orcid.org/0000-0001-8542-6999.
Acad Med. 2019 Jun;94(6):838-846. doi: 10.1097/ACM.0000000000002642.
To explore how multiple stakeholder groups contribute to the understanding of trainee competence.
The authors conducted a constructivist qualitative study in 2015 using focus group discussions to explore the perceptions of different stakeholder groups (patients, nurses/nurse practitioners, supervisors/senior physicians, leaders/administrators, trainees) regarding trainee competence in the emergency department. The authors used a conventional content analysis, a comparative analysis of supervisors'/senior physicians' versus other stakeholders' perspectives, and a directed analysis informed by stakeholder theory to analyze the focus group transcripts.
Forty-six individuals participated in nine focus groups. Four categories of competence were identified: Core Clinical Activities, Patient Centeredness, Aligning Resources, and Code of Conduct. Stakeholders generally agreed in their overall expectations regarding trainee competence. Within individual categories, each stakeholder group identified new considerations, details, and conflicts, which were a replication, elaboration, or complication of a previously identified theme. All stakeholders stressed those aspects of trainee competence that were relevant to their work or values. Trainees were less aware of the patient perspective than that of the other stakeholder groups.
Considering multiple stakeholder perspectives enriched the description and conceptualization of trainee competence. It also can inform the development of curricula and assessment tools and guide learning about inter- and intradisciplinary conflicts. Further research should explore how trainees' perceptions of value are influenced by their organizational context and, in particular, how trainees adapt their learning goals in response to the divergent demands of key stakeholders.
探讨多个利益相关者群体如何有助于理解学员的能力。
作者于 2015 年进行了一项建构主义定性研究，采用焦点小组讨论来探讨不同利益相关者群体（患者、护士/护士从业者、主管/高级医师、领导/管理人员、学员）对急诊部门学员能力的看法。作者使用常规内容分析、主管/高级医师观点与其他利益相关者观点的比较分析以及利益相关者理论指导的定向分析来分析焦点小组记录。
46 人参加了 9 个焦点小组。确定了四个类别的能力：核心临床活动、以患者为中心、协调资源和行为准则。利益相关者总体上对学员能力的总体期望达成一致。在各个类别中，每个利益相关者群体都确定了新的考虑因素、细节和冲突，这些都是之前确定的主题的复制、阐述或复杂化。所有利益相关者都强调了与他们的工作或价值观相关的学员能力方面。与其他利益相关者群体相比，学员对患者的看法认识不足。
考虑到多个利益相关者的观点丰富了学员能力的描述和概念化。它还可以为课程和评估工具的开发提供信息，并指导对跨学科和学科内冲突的学习。进一步的研究应探讨学员对价值的看法如何受到其组织背景的影响，特别是学员如何根据关键利益相关者的不同需求调整他们的学习目标。
