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基于能力的医学教育:回顾过去、现在和后 COVID-19 时代。

Competency-Based Medical Education: Considering Its Past, Present, and a Post-COVID-19 Era.

机构信息

M.S. Ryan is professor and vice chair of education, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.

E.S. Holmboe is chief research, milestone development, and evaluation officer, Accreditation Council for Graduate Medical Education, Chicago, Illinois.

出版信息

Acad Med. 2022 Mar 1;97(3S):S90-S97. doi: 10.1097/ACM.0000000000004535.

Abstract

Advancement toward competency-based medical education (CBME) has been hindered by inertia and a myriad of implementation challenges, including those associated with assessment of competency, accreditation/regulation, and logistical considerations. The COVID-19 pandemic disrupted medical education at every level. Time-in-training sometimes was shortened or significantly altered and there were reductions in the number and variety of clinical exposures. These and other unanticipated changes to existing models highlighted the need to advance the core principles of CBME. This manuscript describes the impact of COVID-19 on the ongoing transition to CBME, including the effects on training, curricular, and assessment processes for medical school and graduate medical education programs. The authors outline consequences of the COVID-19 disruption on learner training and assessment of competency, such as conversion to virtual learning modalities in medical school, redeployment of residents within health systems, and early graduation of trainees based on achievement of competency. Finally, the authors reflect on what the COVID-19 pandemic taught them about realization of CBME as the medical education community looks forward to a postpandemic future.

摘要

向基于能力的医学教育(CBME)的推进受到了惯性和无数实施挑战的阻碍,包括与能力评估、认证/监管以及后勤方面的考虑有关的挑战。COVID-19 大流行扰乱了各个层面的医学教育。培训时间有时缩短或发生重大改变,临床接触的数量和种类也减少了。这些以及对现有模式的其他意外改变凸显了推进 CBME 核心原则的必要性。本文描述了 COVID-19 对正在进行的向 CBME 过渡的影响,包括对医学院和毕业后医学教育项目的培训、课程和评估过程的影响。作者概述了 COVID-19 中断对学习者培训和能力评估的影响,例如医学院转向虚拟学习模式、在卫生系统内重新部署住院医师以及根据能力的实现提前结业。最后,作者反思了 COVID-19 大流行让他们认识到 CBME,因为医学教育界期待着后大流行的未来。

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