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基于价值观的内科-儿科住院医师培训项目住院医师选拔。

Values-Based Resident Selection in an Internal Medicine-Pediatrics Residency Program.

机构信息

Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, USA.

Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA.

出版信息

J Gen Intern Med. 2023 May;38(6):1410-1416. doi: 10.1007/s11606-022-07857-y. Epub 2022 Nov 7.

Abstract

BACKGROUND

There is no consensus regarding values important for medical resident success, and current methods for selecting residents correlate poorly with success in residency.

OBJECTIVE

We developed and validated a set of values demonstrated by exemplary residents in the Internal Medicine-Pediatrics program at the University of Utah and used them to inform our resident selection process.

DESIGN

We utilized a modified Delphi method to identify and internally validate values of successful residents. We implemented these values into the interview evaluation rubric.

PARTICIPANTS

Four members of the Internal Medicine-Pediatrics residency program leadership and eleven current residents aided in value generation. Nine faculty from leadership positions in the residency programs of Internal Medicine-Pediatrics, Internal Medicine, and Pediatrics formed a local expert panel for validation.

APPROACH

We performed a literature review and engaged local stakeholders in a semi-structured group interview to generate 107 values. After consolidation based on redundancy, two iterative cycles of expert review using a modified Delphi approach, and alignment with the Accreditation Council for Graduate Medical Education core competencies, eleven values achieved expert agreement and were integrated into an interview rubric to aid in resident selection.

KEY RESULTS

We identified eleven values important for resident success: academic strength, intellectual curiosity, compassion, communication, work ethic, teamwork, leadership, self-awareness, DEI (diversity, equity, and inclusion), professionalism, and adaptability. The rank list from 2021 was found to correlate with a score based on values, but not Step 2 score, as it did in 2017.

CONCLUSIONS

We applied a modified Delphi method to generate eleven observable values present in the ideal Internal Medicine-Pediatric resident at one academic health center in the Intermountain West. Higher Step 2 scores no longer correlated with higher ranking when we used these values to inform our rank list.

摘要

背景

目前对于医学住院医师成功重要的价值观尚未达成共识,而且当前住院医师选拔方法与住院医师的成功相关性较差。

目的

我们制定并验证了一套内科学-儿科学项目中模范住院医师所表现出的价值观,并将其用于指导我们的住院医师选拔流程。

设计

我们采用改良 Delphi 方法来确定和内部验证成功住院医师的价值观。我们将这些价值观纳入面试评估标准中。

参与者

内科学-儿科学住院医师项目领导层的四位成员和十一位现任住院医师参与了价值观的生成。来自内科学-儿科学、内科学和儿科学住院医师项目领导层的九位教师组成了当地专家小组进行验证。

方法

我们进行了文献回顾,并邀请当地利益相关者参加半结构化小组访谈,以生成 107 项价值观。在基于冗余进行整合后,我们采用改良 Delphi 方法进行了两轮专家评审,并与研究生医学教育认证委员会核心能力保持一致,有十一项价值观获得了专家的一致认可,并被纳入面试评分标准,以帮助选拔住院医师。

主要结果

我们确定了十一项对住院医师成功至关重要的价值观:学术实力、求知欲、同情心、沟通能力、职业道德、团队合作、领导力、自我意识、多样性、公平性和包容性、专业性和适应性。2021 年的排名与基于价值观的分数相关,但与 2017 年的 Step 2 分数无关。

结论

我们在内华达州西部一个学术医疗中心应用改良 Delphi 方法生成了十一项理想的内科学-儿科学住院医师所具备的可观察价值观。当我们使用这些价值观来制定排名时,较高的 Step 2 分数不再与较高的排名相关。

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