Competence Centre for University Teaching in Medicine, Eberhard-Karls University of Tuebingen, Baden-Wuerttemberg, Elfriede-Aulhorn-Str. 10, D-72076, Tuebingen, Germany.
BMC Med Educ. 2020 Feb 4;20(1):35. doi: 10.1186/s12909-020-1940-0.
The Collaborator, Health Advocate and Leader/Manager roles are highly relevant for safe patient management and optimization of healthcare system in rehabilitation and prevention. They are defined in competency-based frameworks and incorporate competencies empowering physicians to master typical daily tasks in interdisciplinary, interprofessional and institutional collaboration. However, appropriate implementation of roles remains difficult in undergraduate medical education (UME) and needs to be closely monitored. The aim of this cross-institutional mapping study was to examine for the roles of Collaborator, Health Advocate and Leader/Manager: (1) To what extent do German UME programs explicitly meet the given standards after 5 years of study? (2) Which information may be obtained from multi-site mapping data for evidence-based reflection on curricula and framework?
In a joint project of eight German UME programs, 80 to 100% of courses were mapped from teachers' perspective against given national standards: (sub-)competency coverage, competency level attainment and assessment. All faculties used a common tool and consented procedures for data collection and processing. The roles' representation was characterized by the curricular weighting of each role content expressed by the percentage of courses referring to it (citations). Data were visualized in a benchmarking approach related to a general mean of the intrinsic roles as reference line.
(Sub-)competencies of the Health Advocate are consistently well-integrated in curricula with a wide range of generally high curricular weightings. The Collaborator reveals average curricular representation, but also signs of ongoing curricular development in relevant parts and clear weaknesses regarding assessment and achieved outcomes. The Leader/Manager displays consistently lowest curricular weightings with several substantial deficiencies in curricular representation, constructive alignment and/or outcome level. Our data allow identifying challenges to be considered by local curriculum developers or framework reviewers (e.g. non-achievement of competency levels, potential underrepresentation, lacking constructive alignment).
Our non-normative, process-related benchmarking approach provides a differentiated crosscut snapshot to compare programs in the field of others, thus revealing shortcomings in role implementation, especially for Leader/Manager and Collaborator. The synopsis of multi-site data may serve as an external reference for program self-assessment and goal-oriented curriculum development. It may also provide practical data for framework review.
在康复和预防领域，协作员、健康倡导者和领导者/管理者的角色对于安全的患者管理和优化医疗体系非常重要。这些角色在基于能力的框架中进行了定义，并纳入了使医生能够掌握跨学科、跨专业和机构协作中典型日常任务的能力。然而，在本科医学教育（UME）中，这些角色的适当实施仍然具有挑战性，需要进行密切监测。本跨机构映射研究的目的是检查协作员、健康倡导者和领导者/管理者的角色：（1）经过 5 年的学习，德国 UME 课程在多大程度上明确符合既定标准？（2）从多站点映射数据中可以获得哪些信息，以便对课程和框架进行基于证据的反思？
在八个德国 UME 课程的联合项目中，从教师的角度对 80%至 100%的课程进行了映射，以符合既定的国家标准：（子）能力涵盖、能力水平的实现和评估。所有学院都使用了一种通用工具和经过同意的程序来进行数据收集和处理。角色的代表性通过课程中每个角色内容的权重来描述，即表示提到该角色的课程的百分比（引用次数）。数据以基准方法进行可视化，将内在角色的总体平均值作为参考线。
健康倡导者的（子）能力在课程中得到了一致的很好整合，课程的权重范围很广，总体上权重较高。协作员的课程代表性平均，但在相关部分也显示出课程发展的迹象，以及在评估和实现结果方面的明显弱点。领导者/管理者的课程权重始终最低，在课程代表性、建设性调整和/或结果水平方面存在几个实质性缺陷。我们的数据可以确定需要由当地课程开发者或框架审查者考虑的挑战（例如，未能达到能力水平、潜在代表性不足、缺乏建设性调整）。
我们的非规范、过程相关的基准方法提供了一个差异化的跨领域快照，可用于比较该领域的其他课程，从而揭示了角色实施方面的不足，尤其是对于领导者/管理者和协作员。多站点数据的概要可作为课程自我评估和以目标为导向的课程开发的外部参考。它也可以为框架审查提供实际数据。
