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结构化路线图、个人责任制与支持以及结果测量对住院医师培训项目学术文化的影响

Impact of a Structured Roadmap, Individual Accountability and Support, and Outcome Measurement on the Culture of Scholarship in a Residency Program.

作者信息

Waheed Abdul, Azhar Erum, Aziz Faisal, Nasir Munima, Chaudhary Muhammad Ali, Wang Li

机构信息

Department of Family Medicine, Dignity Health Medical Group, Gilbert, AZ, USA.

Creighton University School of Medicine, Phoenix, AZ, USA.

出版信息

J Med Educ Curric Dev. 2024 Sep 27;11:23821205241287449. doi: 10.1177/23821205241287449. eCollection 2024 Jan-Dec.

Abstract

BACKGROUND

Despite scholarly activity being an accreditation requirement for residency programs by the Accreditation Council for Graduate Medical Education (ACGME) since 2006, many family medicine programs have struggled to meet this requirement. A myriad of approaches and curricula have been proposed to enhance the scholarly output of residency programs.

OBJECTIVES

To determine the impact of a multimodal curricular intervention consisting of clear expectations, structured roadmap, availability of resources, and standardized accountability on the scholarly activity of residents.

METHODS

This is a quasi-experimental study with a retrospective data collection. The scholarly activities of residents completing training in the pre-intervention (2009-2012) and post-intervention period (2013-2017) were compared. Chi-square, Fisher's exact, Mann Whitney U, and Kruskal Wallis H tests were utilized to detect differences between the pre- and post-intervention groups. Multivariable Poisson regression models were used to detect independent predictors of per-resident scholarly activity. The institutional review board determined that the study was exempt from full review.

RESULTS

A total of 67 residents, 20 (30%) pre-intervention and 47 (70%) post-intervention, were included in the analysis. The number of total scholarly activities per resident increased significantly in the post-intervention period after adjusting for confounding factors (1.9 vs 6.4). The number of scholarly activities per resident also showed an increasing trend over time ( = .04). Moreover, traditional scholarship, including published manuscripts (0.35 vs 2.43) and national-level presentations (0.35 vs 1.27) also increased in the post-intervention period.

CONCLUSION

Implementing this comprehensive curriculum increased the scholarly output of residents and helped enrich the scholarship culture in the residency program.

摘要

背景

尽管自2006年以来学术活动一直是研究生医学教育认证委员会(ACGME)对住院医师培训项目的一项认证要求,但许多家庭医学项目仍难以满足这一要求。人们提出了无数方法和课程来提高住院医师培训项目的学术产出。

目的

确定由明确期望、结构化路线图、资源可用性和标准化问责制组成的多模式课程干预对住院医师学术活动的影响。

方法

这是一项采用回顾性数据收集的准实验研究。比较了在干预前(2009 - 2012年)和干预后时期(2013 - 2017年)完成培训的住院医师的学术活动。使用卡方检验、费舍尔精确检验、曼 - 惠特尼U检验和克鲁斯卡尔 - 沃利斯H检验来检测干预前后组间的差异。多变量泊松回归模型用于检测每位住院医师学术活动的独立预测因素。机构审查委员会确定该研究无需进行全面审查。

结果

共有67名住院医师纳入分析,其中干预前20名(30%),干预后47名(70%)。在调整混杂因素后,干预后时期每位住院医师的学术活动总数显著增加(1.9对6.4)。每位住院医师的学术活动数量也随时间呈上升趋势(P = 0.04)。此外,传统学术成果,包括发表的手稿(0.35对2.43)和国家级报告(0.35对1.27)在干预后时期也有所增加。

结论

实施这一综合课程提高了住院医师的学术产出,并有助于丰富住院医师培训项目的学术文化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bd6/11437589/360794c7681f/10.1177_23821205241287449-fig1.jpg

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