Rebedew David, Bell Theodore, Waheed Abdul, Azhar Erum
Family Medicine Residency Program-Janesville, Department of Family Medicine, Janesville, WI.
WellSpan Health Research Department, York, PA.
Fam Med. 2024 Sep 6;56(10):641-9. doi: 10.22454/FamMed.2024.375189.
From 2020 to 2022, multiple medical schools transitioned from teaching patient care directly to online electives. Family medicine program directors reported on these learners' abilities to meet the Accreditation Council of Graduate Medical Education (ACGME) core competencies during residency. The authors hypothesized an increased need for medical knowledge remediation in the 2023 Council of Academic Family Medicine Educational Research Alliance (CERA) study.
Using the 2017 and 2023 CERA studies, the authors evaluated which factors were associated with residents requiring remediation, residents completing remediation, the duration of remediation, and the most remediated core competency.
Compared to 2017, the percentage of residents who successfully remediated in the 2023 study increased (P=.006), while remediation duration stayed unchanged at 6 to 12 months. The top ACGME core competency needing remediation remained professionalism in both studies (2017: 38.1%; 2023: 45.1%; P=.10) with medical knowledge being second most common (2017: 30.2%; 2023: 25.2%; P=.20). We found no associations between non-U.S. medical graduate percentage, core faculty remediation training, professionalism training, or didactic hours and the number of residents undergoing remediation, the percentage of residents remediating successfully, or the most common competency remediated. Program director gender, degree, race, years of experience, underrepresented in medicine status, and remediation training were not associated with any resident remediation variables studied.
Professionalism remains the top core competency requiring remediation. We found no associations between resident, program, training, or program director factors and the core competency requiring remediation, the number of residents needing remediation, or the percentage of residents who completed remediation.
2020年至2022年期间,多所医学院校从直接教授患者护理过渡到在线选修课。家庭医学项目主任报告了这些学习者在住院医师培训期间达到研究生医学教育认证委员会(ACGME)核心能力要求的能力。作者们推测,在2023年学术家庭医学教育研究联盟(CERA)的研究中,对医学知识补习的需求将会增加。
作者们利用2017年和2023年的CERA研究,评估了哪些因素与需要补习的住院医师、完成补习的住院医师、补习时长以及补习最多的核心能力相关。
与2017年相比,2023年研究中成功完成补习的住院医师比例有所增加(P = 0.006),而补习时长保持在6至12个月不变。在两项研究中,需要补习的ACGME核心能力中排名第一的都是职业素养(2017年:38.1%;2023年:45.1%;P = 0.10),医学知识是第二常见的(2017年:30.2%;2023年:25.2%;P = 0.20)。我们发现,非美国医学毕业生比例、核心教员补习培训、职业素养培训或授课时长与接受补习的住院医师数量、成功补习的住院医师比例或最常补习的能力之间没有关联。项目主任的性别、学位、种族、工作年限、医学领域代表性不足的状况以及补习培训与所研究的任何住院医师补习变量均无关联。
职业素养仍然是需要补习的首要核心能力。我们发现住院医师、项目、培训或项目主任因素与需要补习的核心能力、需要补习的住院医师数量或完成补习的住院医师比例之间没有关联。