Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson Street, MC-1519, Loma Linda, CA, 92354, USA.
Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson Street, MC-1521, Loma Linda, CA, 92354, USA.
Clin Rheumatol. 2020 Jun;39(6):1719-1723. doi: 10.1007/s10067-020-04942-7. Epub 2020 Feb 13.
Competency-based medical education is emphasized by institutions overseeing medical school and postgraduate training worldwide. The high rate of preventable errors in medicine underscores this need. Expanding physician competency beyond the domains of patient care and medical knowledge towards goals that emphasize a more holistic view of the healthcare system is one aspect of this emphasis. The Accreditation Council on Graduate Medical Education (ACGME), which oversees postgraduate training programs in the USA, has recently expanded to oversee training programs internationally. The original ACGME Milestones effort unveiled in 2013 was met with skepticism. Nevertheless, other outcomes-based education programs worldwide, including the CanMEDS framework (Canada), Tomorrow's Doctor (UK), and Scottish Doctor (Scotland), have suggested that milestones do offer advantages. Missing from the milestone rollout, however, was collaborative buy-in from multiple stakeholders such as from clinician-educators. Consequently, Milestones version 2 is in development. Specifically, these will address the need for specialty-specific milestones, and the usage of harmonized milestones. A concise history of the push towards outcomes-based medical education is presented and contextualized for physicians who must embrace the transition from teacher-based to learner-based outcomes.
基于能力的医学教育受到全球医学学校和研究生培训机构的重视。医学领域中高比例的可预防错误突出了这一需求。将医生的能力从患者护理和医学知识扩展到强调更全面的医疗体系目标是这一重点的一个方面。负责监督美国研究生培训项目的研究生医学教育认证委员会（ACGME）最近已扩大到监督国际培训项目。2013 年推出的原始 ACGME 里程碑计划遭到了质疑。尽管如此，全球其他基于成果的教育项目，包括加拿大的 CanMEDS 框架、英国的明日医生和苏格兰医生，都表明里程碑确实有优势。然而，里程碑计划的推出缺乏来自多个利益相关者的协作投入，例如临床教育者。因此，里程碑计划 2.0 正在开发中。具体而言，这些将解决专业特定里程碑和协调使用里程碑的需求。为了必须从基于教师的成果过渡到基于学习者的成果的医生，本文简要介绍了推动基于成果的医学教育的历史，并对其进行了背景介绍。
