Kappy Brandon, Statile Angela, Schumacher Daniel, Lendrum Elizabeth, Herrmann Lisa
Division of Emergency Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (B Kappy and D Schumacher), Cincinnati, Ohio.
Division of Hospital Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (A Statile and L Herrmann), Cincinnati, Ohio.
Acad Pediatr. 2022 May-Jun;22(4):689-697. doi: 10.1016/j.acap.2021.12.023. Epub 2021 Dec 25.
Receiving and integrating feedback is a key to medical trainee development. To assist trainees seeking improvement through daily formative feedback and deliberate practice, the authors created a new skills-based framework called microskills, derived from the Accreditation Council for Graduate Medical Education (ACMGE) milestones and entrustable professional activities. The authors then explored pediatric resident perceptions around the applicability and usefulness of microskills.
The authors conducted 4 qualitative semistructured focus groups of 28 pediatric residents. Focus group prompts asked participants to reflect on microskills as a new feedback modality and microskills in relation to existing feedback and assessment approaches. Focus group transcripts were analyzed through inductive thematic analysis through an iterative process until theoretical saturation was reached.
Participants felt microskills could facilitate skill-building and improvement, allow for consistent, targeted feedback, and establish a practice of coaching. Participants also perceived microskills' future success to be dependent on how the modality is adopted and utilized alongside existing assessment tools.
Trainees found microskills to be a granular, context-based, coaching tool that could improve skill-building and the feedback process. Microskills' emphasis on feedback and their delineation of clinical skills that can be repeatedly practiced has the potential to provide a roadmap for trainee growth. Though microskills could fill a current need in the medical training landscape, they are not a substitute for existing assessment frameworks.
接收并整合反馈是医学实习生成长的关键。为了帮助实习生通过日常形成性反馈和刻意练习来寻求进步,作者创建了一个名为微技能的基于技能的新框架,该框架源自毕业后医学教育认证委员会(ACMGE)的里程碑和可托付的专业活动。作者随后探讨了儿科住院医师对微技能适用性和有用性的看法。
作者对28名儿科住院医师进行了4次定性半结构化焦点小组访谈。焦点小组的提问促使参与者思考微技能作为一种新的反馈方式,以及微技能与现有反馈和评估方法的关系。通过归纳主题分析,对焦点小组的文字记录进行反复分析,直至达到理论饱和。
参与者认为微技能有助于技能培养和提高,能提供一致、有针对性的反馈,并建立指导实践。参与者还认为微技能未来的成功取决于该方式如何与现有评估工具一起采用和使用。
实习生发现微技能是一种细致的、基于情境的指导工具,可改善技能培养和反馈过程。微技能对反馈的强调及其对可反复练习的临床技能的描述,有可能为实习生的成长提供路线图。尽管微技能可以满足医学培训领域当前的需求,但它们不能替代现有的评估框架。