Phelps K A, Taylor C A
Department of Family Medicine, Medical College of Ohio, Toledo, USA.
Fam Med. 1996 Sep;28(8):565-9.
Fifteen years ago, the American Board of Family Practice determined the need for a procedural "core" list requirement for residency training. Program directors at that time could not reach a consensus about a specific list of procedures. This study examined the current attitudes of residency directors about a core list of office-based procedures required for residency training.
A questionnaire was designed to elicit general information about attitudes toward establishing a core requirement of office-based procedures. The program directors were asked to select from a list of 35 office-based procedures those they felt should be required. The questionnaire was mailed to all 421 US family practice residency directors.
The response rate was 78%. Of responding directors, 68% favored a core list requirement. Eleven out of 35 procedures received at least 80% consensus by those directors favoring a core list requirement. Programs situated in rural areas were more likely to oppose the core list requirement. Geographic region of the residency program impacted on the number of core procedures respondents felt residents should master in their training.
The majority of residency directors who responded believe that the potential advantages of a core list requirement outweigh the potential disadvantages. The directors approximated consensus (80% agreement) on seven procedures across all geographic regions. With this evidence in mind, it would seem appropriate for the governing bodies of family practice to reexamine the core procedure issue.
15年前,美国家庭医学委员会确定住院医师培训需要一份程序性“核心”清单要求。当时的项目主任们未能就具体的程序清单达成共识。本研究调查了住院医师培训主任们目前对住院医师培训所需的门诊程序核心清单的态度。
设计了一份问卷,以获取有关对制定门诊程序核心要求的态度的一般信息。要求项目主任从35项门诊程序清单中选出他们认为应要求掌握的程序。问卷被邮寄给了所有421名美国家庭医学住院医师培训主任。
回复率为78%。在回复的主任中,68%赞成核心清单要求。在赞成核心清单要求的主任中,35项程序中有11项获得了至少80%的共识。位于农村地区的项目更有可能反对核心清单要求。住院医师培训项目的地理区域影响了受访者认为住院医师在培训中应掌握的核心程序数量。
大多数回复的住院医师培训主任认为,核心清单要求的潜在优点超过了潜在缺点。主任们在所有地理区域的7项程序上达成了近似共识(80%的一致意见)。考虑到这一证据,家庭医学管理机构重新审视核心程序问题似乎是合适的。