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基于能力的医学教育——迈向标准化儿科放射学测试模块的发展。

Competency Based Medical Education-Towards the Development of a Standardized Pediatric Radiology Testing Module.

机构信息

Department of Radiology, Kingston Health Sciences Centre, Kingston, ON, Canada.

Queen's School of Medicine, Queen's University, Kingston, ON, Canada.

出版信息

Acad Radiol. 2020 Nov;27(11):1622-1632. doi: 10.1016/j.acra.2019.12.005. Epub 2020 Feb 3.

DOI:10.1016/j.acra.2019.12.005
PMID:32029374
Abstract

RATIONALE AND OBJECTIVES

To introduce a process that allows for development of standardized competency based testing modules (CBTM) for evaluating resident progress and competence during their radiology training. This work focuses on the development of pediatric imaging CBTMs to be utilized during general radiology residency.

MATERIALS AND METHODS

Multiple in-patient and ER imaging request audits along with surveys of training programs and text recommendations were obtained. A list of 200 total diagnoses accumulated by review was distributed into one of four CBTM folders. Imaging cases which made ≥90% of the indications of the audits were added to Folder 1. Distribution of remaining imaging diagnoses was based on consensus by three subspecialists. A pilot study was performed with residents dictating selected imaging cases in their usual manner mimicking a typical rotation.

RESULTS

The pilot study demonstrated resident grading mean scores significantly associated with both the American College of Radiology (ACR) rank (rho = 0.636, p = 0.035) and the objective structured clinical examinations (OSCE) scores (rho = 0.694, p = 0.018). The mean scores positively associated with the ACR score (rho = 0.466), but fell short of statistical significance (p = 0.149). As expected, the ACR score, ACR rank and OSCE scores all significantly correlated with each other ( < 0.01). PGY also significantly correlated with the ACR score (rho = 0.683, p = 0.021) and the OSCE (rho = 0.767, p = 0.006) but not with the ACR rank (rho = 0.408, p = 0.213).

CONCLUSION

The process utilized to develop a standardized CBTM can be used as a simulation tool to assess radiology resident competence during their training. The format allows for assessment of resident reasoning skills and knowledge base, which provides documentation of progression and throughout residency.

摘要

背景与目标

引入一种流程,用于开发标准化的基于能力的测试模块(CBTM),以评估住院医师在放射学培训期间的进展和能力。本工作专注于开发儿科影像学 CBTM,以便在普通放射学住院医师培训期间使用。

材料与方法

获得多项住院和急诊影像学请求审核,以及培训计划调查和文本推荐。通过审查积累了 200 项总诊断,将其分配到四个 CBTM 文件夹之一。将审核中≥90%的影像学诊断加入到文件夹 1 中。剩余影像学诊断的分布基于三位专家的共识。对住院医师以通常的方式口述选择的影像学病例进行了试点研究,以模拟典型的轮转。

结果

试点研究表明,住院医师评分的平均分数与美国放射学院(ACR)排名(rho=0.636,p=0.035)和客观结构化临床考试(OSCE)分数(rho=0.694,p=0.018)显著相关。平均分数与 ACR 分数呈正相关(rho=0.466),但未达到统计学意义(p=0.149)。正如预期的那样,ACR 分数、ACR 排名和 OSCE 分数彼此之间显著相关(p<0.01)。PGY 也与 ACR 分数(rho=0.683,p=0.021)和 OSCE(rho=0.767,p=0.006)显著相关,但与 ACR 排名(rho=0.408,p=0.213)不相关。

结论

用于开发标准化 CBTM 的流程可用作评估住院医师培训期间放射学能力的模拟工具。该格式允许评估住院医师的推理技能和知识库,为整个住院医师培训过程提供进展情况的记录。

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