埃塞俄比亚麻醉师执照考试：对相关担忧及意外后果的定性研究

Ethiopian Anesthetist Licensing Examination: A Qualitative Study of Concerns and Unintended Consequences.

作者信息

Asemu Yohannes Molla, Yigzaw Tegbar, Ayalew Firew, Akalu Leulayehu, Scheele Fedde, van den Akker Thomas

机构信息

Health Workforce Improvement Program, Jhpiego, An Affiliate of Johns Hopkins University, Ethiopia Country Office, Addis Ababa, Ethiopia.

Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

出版信息

Adv Med Educ Pract. 2023 Sep 25;14:1055-1064. doi: 10.2147/AMEP.S418743. eCollection 2023.

DOI:10.2147/AMEP.S418743

PMID:37789925

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10542504/

Abstract

BACKGROUND

Ethiopia increased its anesthesia workforce drastically by expanding the training of associate clinician anesthetists. Following this expansion, the Ministry of Health established an entry-level anesthesia licensing examination to ensure patient safety. However, there is limited empirical evidence on the impacts of licensing exams in low- and middle-income countries. This study aimed to explore the concerns and undesirable consequences of the anesthetist licensing examination in Ethiopia.

METHODS

A qualitative design using a grounded theory approach was employed by collecting data from 10 anesthesia teaching institutions. We conducted 15 in-depth interviews with instructors and six focus groups with students and graduates who took the exam recently. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed using Atlas.ti 23. We also extracted secondary data from the academic committee meeting minutes, curricula, faculty appraisal reports, and program quality self-review reports.

RESULTS

Qualitative analysis revealed three central categories of concerns and untoward consequences of the anesthetist NLE: exam management, educational management, and student behavior. Exam management concerns were related to exam validity, fairness, and consistent enforcement of pass/fail decisions. The unintended consequences of the exam on education management were perceived as promoting teaching and learning for the exam, increasing faculty workload, and resulting in superficial and patchy educational reforms. Study participants also reported adverse psychosocial effects and increased cheating behaviors among students as undesirable consequences of the exam on student behavior.

CONCLUSION

Our study identified some concerns and unintended consequences of the Ethiopian anesthetist licensing examination. These lessons learned may contribute to improving the quality of licensing examinations in Ethiopia and beyond.

摘要

背景

埃塞俄比亚通过扩大助理临床麻醉师培训大幅增加了麻醉工作人员数量。在此扩张之后，卫生部设立了入门级麻醉许可考试以确保患者安全。然而，关于低收入和中等收入国家许可考试影响的实证证据有限。本研究旨在探讨埃塞俄比亚麻醉师许可考试存在的问题及不良后果。

方法

采用扎根理论方法进行定性设计，从10个麻醉教学机构收集数据。我们对教员进行了15次深入访谈，并与近期参加考试的学生和毕业生进行了6次焦点小组讨论。访谈和焦点小组讨论进行了录音，逐字转录，并使用Atlas.ti 23进行分析。我们还从学术委员会会议记录、课程、教师评估报告和项目质量自我审查报告中提取了二手数据。

结果

定性分析揭示了麻醉师国家许可考试存在的三类主要问题及不良后果：考试管理、教育管理和学生行为。考试管理方面的问题与考试有效性、公平性以及通过/失败决定的一致执行有关。考试对教育管理产生的意外后果被认为是促进了为考试而进行的教学，增加了教师工作量，并导致了表面化和零散的教育改革。研究参与者还报告说，考试对学生行为产生的不良后果包括学生出现不良心理社会影响以及作弊行为增加。