Babbott D, Halter W D
J Med Educ. 1983 Dec;58(12):947-53. doi: 10.1097/00001888-198312000-00005.
In the study reported here, the authors test the hypothesis that internists completing residencies in a highly structured, problem-oriented residency program approach clinical problem-solving differently than do internists whose residencies were not problem-oriented. The vehicle for the study was the certifying examination of the American Board of Internal Medicine (ABIM) in 1978, 1979, and 1980. Performance on patient management problems (PMPs) and multiple-choice questions was analyzed for candidates for ABIM certification whose residency had been problem-oriented, for candidates whose residencies had been classified as nonproblem-oriented, and for the national pool of U.S. medical graduates. Internists trained in the problem-oriented residency program achieved significantly higher PMP scores than did the national pool in two of the three years and on true-false questions in one of the years. No differences were detected between the problem-oriented group and their nonproblem-oriented colleagues.
在本文所报道的研究中，作者检验了这样一个假设：在高度结构化、以问题为导向的住院医师培训项目中完成培训的内科医生，与那些接受的住院医师培训并非以问题为导向的内科医生相比，临床问题解决方式有所不同。该研究借助的是1978年、1979年和1980年美国内科医学委员会（ABIM）的认证考试。分析了接受过以问题为导向的住院医师培训的ABIM认证考生、住院医师培训被归类为非问题导向型的考生以及美国医学毕业生全国样本在患者管理问题（PMPs）和多项选择题上的表现。在以问题为导向的住院医师培训项目中接受培训的内科医生，在三年中的两年里PMP得分显著高于全国样本，在其中一年的是非题上得分也显著高于全国样本。未发现以问题为导向的组与其非问题导向型的同事之间存在差异。
