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一种新颖的方案评估委员会方法。

A novel approach to the program evaluation committee.

机构信息

Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.

VA Connecticut Healthcare System, Primary Care, Firm B, 950 Campbell Avenue, West Haven, CT, 06516, USA.

出版信息

BMC Med Educ. 2019 Dec 16;19(1):465. doi: 10.1186/s12909-019-1899-x.

Abstract

BACKGROUND

The Accreditation Council for Graduate Medical Education requires each residency program to have a Program Evaluation Committee (PEC) but does not specify how the PEC should be designed. We sought to develop a PEC that promotes resident leadership and provides actionable feedback.

METHODS

Participants were residents and faculty in the Traditional Internal Medicine residency program at Yale School of Medicine (YSM). One resident and one faculty member facilitated a 1-h structured group discussion to obtain resident feedback on each rotation. PEC co-facilitators summarized the feedback in written form, then met with faculty Firm Chiefs overseeing each rotation and with residency program leadership to discuss feedback and generate action plans. This PEC process was implemented in all inpatient and outpatient rotations over a 4-year period. Upon conclusion of the second and fourth years of the PEC initiative, surveys were sent to faculty Firm Chiefs to assess their perceptions regarding the utility of the PEC format in comparison to other, more traditional forms of programmatic feedback. PEC residents and faculty were also surveyed about their experiences as PEC participants.

RESULTS

The PEC process identified many common themes across inpatient and ambulatory rotations. Positives included a high caliber of teaching by faculty, highly diverse and educational patient care experiences, and a strong emphasis on interdisciplinary care. Areas for improvement included educational curricula on various rotations, interactions between medical and non-medical services, technological issues, and workflow problems. In survey assessments, PEC members viewed the PEC process as a rewarding mentorship experience that provided residents with an opportunity to engage in quality improvement and improve facilitation skills. Firm chiefs were more likely to review and make rotation changes in response to PEC feedback than to traditional written resident evaluations but preferred to receive both forms of feedback rather than either alone CONCLUSIONS: The PEC process at YSM has transformed our program's approach to feedback delivery by engaging residents in the feedback process and providing them with mentored quality improvement and leadership experiences while generating actionable feedback for program-wide change. This has led to PEC groups evaluating additional aspects of residency education.

摘要

背景

研究生医学教育认证委员会要求每个住院医师培训计划都有一个项目评估委员会(PEC),但没有具体说明 PEC 应该如何设计。我们旨在开发一种促进住院医师领导力并提供可操作反馈的 PEC。

方法

参与者是耶鲁大学医学院(YSM)传统内科住院医师培训计划的住院医师和教师。一位住院医师和一位教师主持了 1 小时的结构化小组讨论,以获得住院医师对每个轮转的反馈。PEC 联合主持人以书面形式总结反馈,然后与监督每个轮转的教师 Firm Chief 和住院医师培训计划领导讨论反馈并制定行动计划。在四年的时间里,这种 PEC 流程在所有住院和门诊轮转中实施。在 PEC 计划启动的第二年和第四年结束时,向教师 Firm Chief 发送了调查,以评估他们对 PEC 格式相对于其他更传统的计划反馈形式的实用性的看法。还对 PEC 住院医师和教师进行了调查,以了解他们作为 PEC 参与者的经验。

结果

PEC 流程在住院和门诊轮转中确定了许多共同的主题。积极的方面包括教师的高水平教学、高度多样化和教育性的患者护理经验以及对跨学科护理的强烈重视。需要改进的领域包括各个轮转的教育课程、医疗和非医疗服务之间的互动、技术问题和工作流程问题。在调查评估中,PEC 成员认为 PEC 流程是一种有益的指导经验,为住院医师提供了参与质量改进和提高促进技能的机会。Firm Chief 更有可能根据 PEC 反馈审查和进行轮转变更,而不是根据传统的书面住院医师评估,但他们更喜欢同时收到这两种形式的反馈,而不是只收到其中一种。

结论

YSM 的 PEC 流程通过让住院医师参与反馈过程并为他们提供指导下的质量改进和领导力经验,同时为整个计划的变革提供可操作的反馈,从而改变了我们计划的反馈方式。这导致 PEC 小组评估了住院医师教育的其他方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fff7/6916454/acc69ac42b52/12909_2019_1899_Fig1_HTML.jpg

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