Ballarat Health Services, Ballarat, Victoria, Australia.
Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2021 Jun;61(3):454-462. doi: 10.1111/ajo.13324. Epub 2021 Mar 27.
Competency-based medical education (CBME) is increasingly employed by postgraduate training programs worldwide, including obstetrics and gynaecology. Focusing on assessment of outcomes rather than time-in-training, and utilising a well-defined curricular framework, CBME aims to train doctors capable of meeting the needs of modern society. When this study was undertaken, in 2019, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) had a time-based curriculum and was due to undergo a curriculum review starting in 2020.
To explore Victorian RANZCOG Integrated Training Program (ITP) coordinators' understanding of the concept of competency and how it is taught and assessed within RANZCOG training.
A qualitative, grounded theory design using semi-structured interviews was employed. Victorian RANZCOG ITP coordinators from inner and outer metropolitan, and regional sites, were approached to participate. Transcripts were coded and analysed using thematic analysis.
Themes identified were: Competence, Vision and Innovation, Structures, ITP Coordinator Role and Teaching and Learning. Competence was defined as a combination of independent practice and understanding of ones' own limits, in addition to required clinical skills and knowledge. Enablers and barriers to achieving competency were identified and associated with structures, human and logistical factors. Victorian ITP coordinators believed the current training program has positive elements but could be further improved.
Several areas for future research were identified regarding understanding of competency, relevant if RANZCOG is to introduce a CBME framework. Replicating this research across all RANZCOG jurisdictions in Australia and New Zealand would be prudent to determine if the themes are universal.
以能力为基础的医学教育（CBME）在全球范围内的研究生培训项目中越来越多地被采用，包括妇产科。它侧重于评估结果而不是培训时间，并且利用明确的课程框架，旨在培养能够满足现代社会需求的医生。在进行这项研究时，即 2019 年，澳大利亚皇家妇产科医师学院（RANZCOG）采用了基于时间的课程，并且计划从 2020 年开始进行课程审查。
探索维多利亚州 RANZCOG 综合培训计划（ITP）协调员对能力概念的理解，以及 RANZCOG 培训中教授和评估能力的方式。
采用半结构化访谈的定性扎根理论设计。联系了来自内城和外城、以及地区的维多利亚州 RANZCOG ITP 协调员参与。使用主题分析对转录本进行编码和分析。
确定的主题包括：能力、愿景和创新、结构、ITP 协调员角色以及教学和学习。能力被定义为独立实践和对自身局限性的理解的结合，此外还包括所需的临床技能和知识。确定了实现能力的促进因素和障碍，并将其与结构、人力和后勤因素联系起来。维多利亚州的 ITP 协调员认为当前的培训计划有积极的因素，但可以进一步改进。
确定了未来关于对能力的理解、以及 RANZCOG 引入 CBME 框架的相关研究的几个领域。在澳大利亚和新西兰的所有 RANZCOG 司法管辖区复制这项研究，以确定主题是否具有普遍性，这将是明智之举。
