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住院医师临床培训(ReCEnT)项目的教育与研究效用:运用背景、投入、过程与产出(CIPP)框架对机制的探索

Educational and research utility of the registrar clinical encounters in training (ReCEnT) project: an exploration of mechanisms using the context, input, process and product (CIPP) framework.

作者信息

Tran Michael, Wearne Susan, Davey Andrew, Magin Parker

机构信息

Discipline of General Practice, School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

Academic Unit of General Practice, Australian National University, Canberra, Australian Capital Territory, Australia.

出版信息

Fam Med Community Health. 2025 Jul 21;13(3):e003289. doi: 10.1136/fmch-2025-003289.

Abstract

BACKGROUND

The Registrar Clinical Encounters in Training (ReCEnT) project is an Australian general practice vocational training programme with integrated and interdependent education and research functions. Trainees (registrars) contemporaneously document in-consultation clinical experience and actions.

OBJECTIVES

Using a realist lens, we elucidate the mechanisms underpinning project outcomes to answer questions around programme effectiveness, impacts, sustainability and the lessons and findings that are translatable to other primary care training programmes.

METHODS

The context, input, process and product framework was used. As a means to understand the interactions between each of the interdependent components, it allows for inferences regarding causal mechanisms for specific outcomes.

RESULTS

Context: ReCEnT occurs within an apprenticeship-like model of general practice vocational training entailing a central supervisor/apprentice relationship. ReCEnT has demystified the content and characteristics of registrar consultations. Input: multiple stakeholder involvement is both advantageous and a logistical challenge, with the programme's success dependent on registrars, practices and training providers providing detailed and accurate data, with prompt subsequent processing.

PROCESS

contemporaneous consultation data collection in different stages of training constitutes a component of registrars' programmatic assessment. Product: individualised feedback provides educational benefit through reflection. Clinical and educational research questions can be addressed with resulting research translation feeding back into the programme model and government policy. Clinical behaviour change is also evaluated.

CONCLUSION

ReCEnT is unique, globally, in its scope and longevity (2010-present). Creation of meaningful, individualised feedback facilitates reflection and provides both immediate educational benefits and the substrate for further research, programme and policy design and targeted formal teaching and learning.

摘要

背景

注册临床培训中的会诊(ReCEnT)项目是一项澳大利亚全科医学职业培训计划,具有综合且相互依存的教育与研究功能。学员(注册医生)同时记录会诊中的临床经验和行动。

目的

运用现实主义视角,我们阐明支撑项目成果的机制,以回答有关项目有效性、影响、可持续性以及可转化至其他初级保健培训项目的经验教训和研究发现等问题。

方法

采用背景、投入、过程和产出框架。作为理解各相互依存组成部分之间相互作用的一种方式,它有助于推断特定结果的因果机制。

结果

背景:ReCEnT存在于类似学徒制的全科医学职业培训模式中,涉及核心督导/学徒关系。ReCEnT已揭开注册医生会诊的内容和特点的神秘面纱。投入:多利益相关方参与既有利也带来后勤挑战,项目的成功取决于注册医生、医疗机构和培训提供者提供详细准确的数据,并随后迅速进行处理。

过程

在培训的不同阶段同步收集会诊数据是注册医生课程评估的一个组成部分。产出:个性化反馈通过反思提供教育益处。临床和教育研究问题可通过研究转化来解决,研究结果反馈到项目模式和政府政策中。同时也评估临床行为的改变。

结论

ReCEnT在全球范围内,在其规模和存续时间(2010年至今)方面都独具特色。创建有意义的个性化反馈有助于反思,并提供即时的教育益处以及进一步研究、项目和政策设计以及有针对性的正式教学的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66ad/12281318/de5c9c8edd15/fmch-13-3-g001.jpg

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