Department of Pediatrics, Maastricht UMC+, Maastricht, The Netherlands
Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre, Maastricht, The Netherlands.
BMJ Open. 2022 Aug 17;12(8):e060682. doi: 10.1136/bmjopen-2021-060682.
Stimulating the active participation of residents in projects with societally relevant healthcare themes, such as value-based healthcare (VBHC), can be a strategy to enhance competency development. Canadian Medical Education Directions for Specialists (CanMEDS) competencies such as leader and scholar are important skills for all doctors. In this study, we hypothesise that when residents conduct a VBHC project, CanMEDS competencies are developed. There is the added value of gaining knowledge about VBHC.
An explorative mixed-methods study assessing residents' self-perceived learning effects of conducting VBHC projects according to three main components: (1) CanMEDS competency development, (2) recognition of VBHC dilemmas in clinical practice, and (3) potential facilitators for and barriers to implementing a VBHC project. We triangulated data resulting from qualitative analyses of: (a) text-based summaries of VBHC projects by residents and (b) semistructured interviews with residents who conducted these projects.
Academic and non-academic hospitals in the Netherlands.
Out of 63 text-based summaries from residents, 56 were selected; and out of 19 eligible residents, 11 were selected for semistructured interviews and were included in the final analysis.
Regarding CanMEDS competency development, the competencies 'leader', 'communicator' and 'collaborator' scored the highest. Opportunities to recognise VBHC dilemmas in practice were mainly stimulated by analysing healthcare practices from different perspectives, and by learning how to define costs and relate them to outcomes. Finally, implementation of VBHC projects is facilitated by a thorough investigation of a VBHC dilemma combined with an in-depth stakeholder analysis.
In medical residency training programmes, competency development through active participation in projects with societally relevant healthcare themes-such as VBHC-was found to be a promising strategy. From a resident's perspective, combining a thorough investigation of the VBHC dilemma with an in-depth stakeholder analysis is key to the successful implementation of a VBHC project.
激发住院医师积极参与具有社会相关性的医疗主题项目，如基于价值的医疗保健（VBHC），这可能是增强能力发展的策略。加拿大医学教育专科方向（CanMEDS）的能力，如领导者和学者，是所有医生的重要技能。在这项研究中，我们假设当住院医师进行 VBHC 项目时，CanMEDS 能力会得到发展。此外，还可以获得关于 VBHC 的知识。
一项探索性混合方法研究，根据三个主要组成部分评估住院医师在进行 VBHC 项目时的自我感知学习效果：（1）CanMEDS 能力发展，（2）在临床实践中识别 VBHC 困境，以及（3）实施 VBHC 项目的潜在促进因素和障碍。我们对以下数据进行了三角分析：（a）住院医师基于文本的 VBHC 项目摘要，以及（b）对进行这些项目的住院医师进行的半结构化访谈。
荷兰的学术和非学术医院。
从住院医师的 63 份基于文本的摘要中选择了 56 份；从 19 名符合条件的住院医师中选择了 11 名进行半结构化访谈，并纳入最终分析。
在 CanMEDS 能力发展方面，得分最高的是“领导者”、“沟通者”和“合作者”这三个能力。在实践中识别 VBHC 困境的机会主要通过从不同角度分析医疗保健实践以及学习如何定义成本并将其与结果联系起来来激发。最后，通过彻底调查 VBHC 困境并进行深入的利益相关者分析，可以促进 VBHC 项目的实施。
在医学住院医师培训计划中，通过积极参与具有社会相关性的医疗主题项目（如 VBHC）来发展能力，被认为是一种有前途的策略。从住院医师的角度来看，将 VBHC 困境的彻底调查与深入的利益相关者分析相结合是成功实施 VBHC 项目的关键。
