談如何在地落實CBME：以台灣急診醫學為例

Implementation of Competency-Based Medical Education with a Local Context in a Taiwan Emergency Medicine Residency Training Program

蕭政廷(Cheng-Ting Hsiao) ； 楊志偉(Chih-Wei Yang) ； 周致丞(Fremen Chih-Chen Chou)

《台灣醫學》 22卷1期 (2018/01) Pp. 55-61

https://doi.org/10.6320/FJM.201801_22(1).0006

摘要

勝任能力導向的醫學教育(competency-based medical education, CBME)近十年在國際間，無論是教育實務或教育研究發展都有超乎想像的快速進展，台灣急診醫學會自2011年來積極推動CBME的台灣在地化發展，是台灣第一個系統性規劃、研究與實施CBME的專科醫學會。本文彙整台灣急診醫學在地化推動CBME的經驗，提出在地推動CBME時需要注意的概念與做法，並輔以台彎急診醫學會的五點經驗作為說明，這五點如下：(1)核心理論全球化、架構內容在地化；(2)過程透明、方法嚴謹；(3)循序師培；(4)評量工具、資訊輔助；(5)共識能力進展、促進適性發展等，值得其他專科醫學會或組織在規劃實施勝任能力醫學教育時參考。

關鍵字

勝任能力醫學教育 ； 里程碑 ； 可信賴專業活動 ； 急診醫學 ； 工作場所評量

並列摘要

Five key points were identified through the process of localization of competency-based medical education (CBME) in Taiwan emergency medicine: (1) ＂Think globally, act locally:＂ adopted and updated universal core concepts, but the framework and content were localized. (2) The process was transparent and the methods were solid. (3) Step-by-step faculty development. (4) Developing assessment tools and applying information technology. (5) Utilizing committee consensus on daily data to inform the trainees' progress of competency and promoting adapted learning for learners. These five concepts and strategies will be helpful for those specialties planning to implement CBME.

並列關鍵字

competency-based medical education(CBME) ； milestone ； entrustable professional activities(EPAs) ； emergency medicine ； workplace assessment

參考文獻

Yang CW, Hsiao CT, Chou FC: Emergency Medicine Milestone Project for Residency Training in Taiwan. J Med Education 2017;21:73-80.

Frank JR, Snell LS, ten Cate O, et al: Competency-based medical education: theory to practice. Med Teach 2010; 32: 638-45.

Carraccio C, Wolfsthal SD, Englander R, et al: Shifting paradigms: from Flexner to competencies. Academic Medicine 2002;77: 361-7.

Miller GM: The assessment of clinical skills/competence/performance. Acad Med 1990;65:63-S67.

Kogan JR, Conforti LN, Iobst WF, et al: Reconceptualizing variable rater assessments as both an educational and clinical care problem. Acad Med 2014;89:721-7.