Valeriano Ailish, Kim Andrew, Katsoulas Eleni, Sanfilippo Anthony, Wang Louie, Rajaram Akshay
School of Medicine, Queen's University, Kingston, ON Canada.
Department of Medicine, Queen's University, Kingston, ON Canada.
Med Sci Educ. 2021 May 21;31(4):1361-1367. doi: 10.1007/s40670-021-01313-y. eCollection 2021 Aug.
The implementation of competency-based medical education in Canada has presented both unique opportunities and challenges for improving undergraduate procedural skills curricula. Despite the recognized importance of procedural skills, there remains a lack of national congruency in procedural training across medical schools that must be addressed. When undertaking such curricular development, obtaining learner feedback is a crucial step that can facilitate practical changes and address disparities. The purpose of the current study is to explore the perspectives and insights of recent medical graduates surrounding the clerkship procedural skills curriculum at a Canadian medical school. Six residents from a variety of program specialties participated in a semi-structured focus group interview discussing key aspects of procedural skill training. The focus group was later transcribed and qualitatively analyzed for themes. The results highlight barriers to competency-based procedural skill training involving time constraints and obtaining required evaluations, and the ability of students to self-advocate for learning opportunities. Participants note few opportunities to practice nasogastric tube insertion and casting in particular. Recommendations for curricular improvement are discussed, including options for curricular remediation and resident perspectives on which procedural skills undergraduate trainees should achieve competency in by graduation.
加拿大实施基于能力的医学教育,为改进本科程序技能课程带来了独特的机遇和挑战。尽管程序技能的重要性已得到认可,但医学院校之间的程序培训在全国范围内仍缺乏一致性,这一问题亟待解决。在进行此类课程开发时,获取学习者的反馈是至关重要的一步,它有助于推动实际变革并解决差异问题。本研究的目的是探讨加拿大一所医学院近期医学毕业生对临床实习程序技能课程的看法和见解。来自不同专业项目的六名住院医师参与了一次半结构化焦点小组访谈,讨论程序技能培训的关键方面。焦点小组访谈内容随后被转录并进行定性分析以找出主题。研究结果突出了基于能力的程序技能培训所面临的障碍,包括时间限制和获得所需评估的困难,以及学生自我争取学习机会的能力。参与者指出,特别是在鼻胃管插入术和石膏固定方面,几乎没有实践机会。文中讨论了课程改进的建议,包括课程补救的选项以及住院医师对于本科实习生毕业时应掌握哪些程序技能才能达到能力要求的看法。