许多儿科亚专业住院医师在两年内尚未准备好结束住院医师培训。

Many Pediatric Subspecialty Fellows Are Not Ready to Graduate From Fellowship in 2 Years.

作者信息

Pitts Sarah, Schwartz Alan, Langhan Melissa L, High Pamela, James Scott H, Karnik Ruchika, Aye Tandy, Boyer Donald L, Stafford Diane E J, Rama Jennifer A, Robinson Bradley W, Hsu Deborah, Moffatt Mary E, Sauer Cary, Mehta Jay J, Atlas Mark P, McGann Kathleen A, Chess Patricia R, Curran Megan L, Weiss Pnina, Mahan John D, McFadden Vanessa, Kamin Daniel S, Kesselheim Jennifer, Czaja Angela S, Dammann Christiane E L, Fussell Jill, George Roshan P, Herman Bruce E, Lopez Michelle A, Torres Orquidia, Turner David A, Mink Richard

机构信息

Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.

University of Illinois College of Medicine at Chicago, Chicago, IL.

出版信息

Pediatrics. 2025 Apr 1;155(4). doi: 10.1542/peds.2024-068307.

DOI:10.1542/peds.2024-068307

PMID:40090359

Abstract

BACKGROUND AND OBJECTIVES

The American Board of Pediatrics requires that proposed changes to the duration of pediatric subspecialty training must include a framework for competency assessment with a measurement component. We analyzed the clinical Entrustable Professional Activity (EPA) level of supervision ratings across 3-year pediatric fellowships to determine if trainees met the minimum thresholds for graduation after 2 years of fellowship training.

METHODS

From spring 2019 through spring 2022, Clinical Competency Committees (CCCs) reported fellow supervision level ratings for all clinical EPAs, fellowship program directors (FPDs) assessed the scholarship EPA supervision level, and fellows self-reported their required level of supervision for all EPAs. Ratings were compared with minimum supervision level thresholds for fellow graduation previously identified by FPDs. We analyzed the proportion of fellows achieving these EPA supervision level thresholds after 2 and 3 years of training.

RESULTS

CCCs reported ratings for 1538 second-year and 1505 third-year fellows. Fewer than 50% of fellows met clinical EPA supervision level thresholds for graduation after 2 years of training, increasing to 86%-100% across subspecialties at 3 years. Fellow self-assessment aligned well with CCC ratings. FPDs reported that 64%-68% of fellows across subspecialties met the scholarship EPA supervision level threshold for graduation after 2 years compared with 99%-100% at 3 years.

CONCLUSIONS

As pediatric fellowships are currently structured and using an EPA assessment framework, many trainees are not ready to graduate after 2 years.

摘要

背景与目的

美国儿科学会要求，对儿科亚专业培训时长的拟议变更必须包含一个带有测量组件的能力评估框架。我们分析了3年儿科专科培训中临床可托付专业活动（EPA）的监督评级水平，以确定学员在2年专科培训后是否达到毕业的最低门槛。

方法

从2019年春季到2022年春季，临床能力委员会（CCC）报告了所有临床EPA的学员监督水平评级，专科培训项目主任（FPD）评估了学术EPA的监督水平，学员自我报告了他们对所有EPA所需的监督水平。将评级与FPD先前确定的学员毕业最低监督水平阈值进行比较。我们分析了培训2年和3年后达到这些EPA监督水平阈值的学员比例。

结果

CCC报告了1538名二年级和1505名三年级学员的评级。在2年培训后，不到50%的学员达到临床EPA监督水平毕业阈值，3年时各亚专业这一比例增至86%-100%。学员自我评估与CCC评级高度一致。FPD报告称，各亚专业64%-68%的学员在2年后达到学术EPA监督水平毕业阈值，而3年后这一比例为99%-100%。