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探索家庭医学住院医师培训课程改革实施后的变化。

Exploring Change After Implementation of Family Medicine Residency Curriculum Reform.

作者信息

Zhang Peter Z, Hamza Deena M, Ross Shelley, Oandasan Ivy

机构信息

University of Toronto.

University of Alberta Department of Family Medicine, Alberta, Edmonton, Canada.

出版信息

Fam Med. 2019 Apr;51(4):331-337. doi: 10.22454/FamMed.2019.427722.

Abstract

BACKGROUND AND OBJECTIVES

In 2010, the College of Family Physicians of Canada (CFPC) launched its competency-based medical education (CBME) approach to residency curriculum and assessment. Named Triple C, this innovation was developed to ensure graduates of family medicine training programs are competent to begin unsupervised practice. Further, Triple C was intended to promote interest in practicing comprehensive family medicine. A program evaluation plan was launched by the CFPC alongside the implementation of Triple C to explore if intended outcomes were achieved.

METHODS

We conducted retrospective secondary data analysis of survey findings from graduating family medicine residents from two sources: National Physician Survey (NPS 2007 and 2010); and the Family Medicine Longitudinal Survey (FMLS 2015). Demographics and practice intentions reported by residents in the NPS 2007, NPS 2010, and FMLS 2015 were included in the analyses and a comparison between years was undertaken using a series of Pearson χ2 test.

RESULTS

Findings indicate that in comparison to pre-Triple C (NPS 2007 and NPS 2010), significantly more residents reported the intention to include palliative care, intrapartum care, in-patient hospital care, care in the home, and practicing in rural settings after the implementation of Triple C (FMLS 2015; P<0.01).

CONCLUSIONS

Family medicine graduates report an increase in intention to include a broader range of clinical domains after implementation of Triple C. While a causal relationship cannot be determined, using a historical control in the form of survey data that predates Triple C implementation could support future approaches to evaluation of education reform.

摘要

背景与目标

2010年,加拿大家庭医生学院(CFPC)推出了基于能力的医学教育(CBME)方法用于住院医师课程和评估。这项名为“Triple C”的创新举措旨在确保家庭医学培训项目的毕业生有能力开始独立执业。此外,“Triple C”旨在提高对从事综合家庭医学的兴趣。CFPC在实施“Triple C”的同时启动了一项项目评估计划,以探讨是否实现了预期成果。

方法

我们对来自两个来源的家庭医学住院医师毕业生的调查结果进行了回顾性二次数据分析:全国医生调查(2007年和2010年);以及家庭医学纵向调查(2015年)。分析纳入了2007年、2010年全国医生调查以及2015年家庭医学纵向调查中住院医师报告的人口统计学和执业意向,并使用一系列Pearson χ2检验对各年份进行比较。

结果

研究结果表明,与“Triple C”实施前(2007年和2010年全国医生调查)相比,在“Triple C”实施后(2015年家庭医学纵向调查),更多住院医师表示有意提供姑息治疗、产时护理、住院医院护理、居家护理,并在农村地区执业(P<0.01)。

结论

家庭医学毕业生报告称,在实施“Triple C”后,他们有意涵盖更广泛临床领域的意愿有所增加。虽然无法确定因果关系,但以“Triple C”实施前的调查数据形式使用历史对照可能有助于未来评估教育改革的方法。

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