Kennedy Geneva, Jacobs Nicole, Freemark Lily, Madan Simran, Chan Natalie, Tran Yvonne, Miller Patricia A
MSc Physiotherapy Program, School of Rehabilitation Science, McMaster University, Hamilton, Canada.
J Contin Educ Health Prof. 2022 Jan 1;42(1):36-46. doi: 10.1097/CEH.0000000000000377.
Clinical competence is essential for providing safe, competent care and is regularly assessed to ensure health care practitioners maintain competence. When deficiencies in competence are identified, practitioners may undergo remediation. However, there is limited evidence regarding the effectiveness of remediation programs. The purpose of this review is to examine the purpose, format, and outcomes of remediation programs for regulated health care practitioners.
All six stages of the scoping review process as recommended by Levac et al were undertaken. A search was conducted within MEDLINE, Embase, CINAHL, ERIC, gray literature databases, and websites of Canadian provincial regulatory bodies. Emails were sent to Registrars of Canadian regulatory bodies to supplement data gathered from their websites.
A total of 14 programs were identified, primarily for physicians (n = 8). Reasons for remediation varied widely, with some programs identifying multiple reasons for referral such as deficiencies in recordkeeping (n = 7) and clinical skills (n = 6). Most programs (n = 9) were individualized to address specific deficiencies in competence. The process of remediation followed three stages: (1) assessment, (2) active remediation, and (3) reassessment. Most programs (n = 12) reported that remediation was effective in improving competence.
Regulatory bodies should consider implementing individualized remediation programs to ensure that clinicians' deficiencies in competence are addressed effectively. Further research is indicated, using reliable and valid outcome measures to assess competence immediately after remediation programs and beyond.
临床能力对于提供安全、胜任的护理至关重要，并且会定期进行评估以确保医疗保健从业者保持胜任能力。当发现能力不足时，从业者可能会接受补救措施。然而，关于补救计划有效性的证据有限。本综述的目的是研究受监管医疗保健从业者补救计划的目的、形式和结果。
按照Levac等人建议的范围综述过程的所有六个阶段进行。在MEDLINE、Embase、CINAHL、ERIC、灰色文献数据库以及加拿大省级监管机构的网站中进行了搜索。向加拿大监管机构的注册官发送了电子邮件，以补充从其网站收集的数据。
共确定了14个计划，主要针对医生（n = 8）。补救的原因差异很大，一些计划确定了多种转诊原因，如记录保存不足（n = 7）和临床技能不足（n = 6）。大多数计划（n = 9）是个性化的，以解决特定的能力不足问题。补救过程包括三个阶段：（1）评估，（2）积极补救，以及（3）重新评估。大多数计划（n = 12）报告称补救在提高能力方面是有效的。
监管机构应考虑实施个性化的补救计划，以确保有效解决临床医生的能力不足问题。需要进一步开展研究，使用可靠且有效的结果指标在补救计划后及之后立即评估能力。
