Castellanos-Ortega Álvaro, Broch Porcar María Jesús, Palacios-Castañeda Diego, Gómez-Tello Vicente, Valdivia Miguel, Vicent Carlos, Madrid Isabel, Martinez Nuria, Párraga Manuel José, Sancho Elena, Fuentes-Dura María Del Castillo, García-Ros Rafael
Intensive Care Department. Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Intensive Care Department. Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Med Intensiva (Engl Ed). 2025 Jun;49(6):502126. doi: 10.1016/j.medine.2024.502126. Epub 2025 Jan 3.
The main objective of this study was to evaluate whether the implementation of CoBaTrICE (Competency-Based Training in Intensive Care Medicine in Europe) provides higher levels of competency in comparison with the current official time-based program in Intensive Care Medicine in Spain. Secondary objectives were: 1) To determine the percentage of critical essential performance elements (CEPE) accomplished, 2) To determine compliance with workplace-based assessments (wba).
Multicenter cluster randomized trial.
Thirteen Spanish ICU Departments.
Thirty-six residents INTERVENTION: The implementation of CoBaTrICE included: (1) Training the trainers; (2) Wba; (3) The use of an electronic portfolio. The level of competency achieved by each participant was determined by a simulation-based Objective Structured Clinical Exam (OSCE) performed at the end of the 5th year of training period.
Total scoring in the five scenarios, CEPE completed, level of competency (1-5) achieved.
A total of 119 performances from 26 residents (17 from CoBaTrICE group and 9 from control group) were analyzed in the OSCE. CoBaTrICE residents´ achieved higher levels of competency [2 (1-5) vs. 2 (1-3), p = 0.07) and higher percentages of CEPE´s accomplishment than the control group (78% vs. 71%, p = 0.09).
The CoBaTrICE group showed a better performance trend in comparison to the control group, but the differences were not statistically significant. Since the number of Wba performed was low, additional research is needed to determine the potential superiority of CoBaTrICE.
本研究的主要目的是评估与西班牙目前官方基于时间的重症医学项目相比，实施欧洲重症医学基于能力的培训（CoBaTrICE）是否能提供更高水平的能力。次要目的为：1）确定关键基本绩效要素（CEPE）的完成百分比；2）确定基于工作场所评估（wba）的依从性。
多中心整群随机试验。
西班牙13个重症监护病房。
36名住院医师
CoBaTrICE的实施包括：（1）培训培训师；（2）基于工作场所评估；（3）使用电子档案袋。每位参与者所达到的能力水平由培训期第5年末进行的基于模拟的客观结构化临床考试（OSCE）确定。
五个场景中的总得分、完成的CEPE、达到的能力水平（1 - 5级）。
在OSCE中分析了来自26名住院医师（17名来自CoBaTrICE组，9名来自对照组）的总共119次表现。CoBaTrICE组住院医师达到了更高的能力水平[2（1 - 5级）对2（1 - 3级），p = 0.07]，且CEPE完成百分比高于对照组（78%对71%，p = 0.09）。
与对照组相比，CoBaTrICE组显示出更好的表现趋势，但差异无统计学意义。由于进行基于工作场所评估的次数较少，需要进一步研究以确定CoBaTrICE的潜在优势。
