探討師資培訓計畫對PGY1臨床教師教授與評估PGY1住院醫師六大核心能力技巧的效果

Effects of the "Training Program for PGY1 Clinical Teacher" on Teaching and Evaluation Skills of ACGME Six Core-Competencies of PGY1 Residents

楊盈盈(Ying-Ying Yang) ； 李發耀(Fa-Yauh Lee) ； 徐會棋(Hui-Chi Hsu) ； 莊喬琳(Chiao-Lin Chuang) ； 李文興(Wei-Shin Lee) ； 張景智(Ching-Chih Chang) ； 陳震寰(Chen-Huan Chen) ； 葉振聲(Tjin-Shing Jap) ； 鄭浩民(Hao-Min Cheng) ； 黃金洲(Chin-Chou Huang) ； 黃加璋(Chia-Chang Huang) ； 戴政宏(Cheng-Hung Tai)

《Journal of Medical Education》 15卷2期 (2011/06) Pp. 120-133

https://doi.org/10.6145/jme.201106_15(2).0006

摘要

背景及目的：訓練具備六大核心能力的PGY1住院醫師前，須先協助臨床教師學習如何教導六大核心能力。方法：民國98-99年間，台北榮民總醫院一般醫學訓練示範中心「一般醫學師資培育計畫」合計培訓117位PGY1臨床教師。利用問卷分析，探討本中心訓練課程，對受訓教師教授六大核心能力之培訓成果。結果：研究發現，受訓教師中，以內科系、資深及曾擔任PGY1臨床教師者，最能運用所學去教導PGY1住院醫師。我們發現受訓教師中，實際平均應用的教學技巧大多是由資深教授巡迴床邊查房教學(itinerant)、床邊查房教學(circuit) bedside teaching、研習營(training camp)及影片賞析(video watching)等四種訓練活動中學習到的。大部分的受訓教師都認同，本訓練計畫所教授的醫師六大核心能力之內涵，確實可以相當程度的符合社會對醫師的期待。而受訓教師們表示能學到最多六大核心能力教學技巧的訓練活動主要包括門診教學(OPD teaching)、以病例為導向之討論評量(CbD evaluation)及研習營等。若要完整有效的增強及改善受訓教師們對六大核心能力之態度及熟悉度，則要靠40小時基礎臨床教學實務訓練、研習營和影片賞析等訓練活動。結論：本研究之成果，可以做為本中心未來在規劃『師資培育計劃』的不同訓練教學模式時改善的依據。除此以外，本研究的結果也可以讓我們了解，本中心所設計之訓練模式中學到的教學技巧，可能被所有受訓的PGY1臨床教師們最後運用的場所。

關鍵字

六大核心能力 ； PGY1臨床教師 ； PGY1住院醫師

並列摘要

Background and Aims: In order to train PGY1 residents, we should help PGY1 clinical teachers to familiar with the teaching and assessment of ACGME six core competencies. Methods: During 2009 to 2010 years, the ”training program for clinical teachers” of the training demonstration center for general medicine of our hospital had trained 117 PGY1 clinical teachers. Our study used questionnaires analysis to evaluate the effectiveness of the training activities of our center on the teaching and evaluation of PGY1 clinical teachers for six core-competencies. Results: The average degree of application of competency instructional skills was markedly higher for participants from internal medicine, with longer years as teachers, previous experience of being as PGY1 clinical teachers. Additionally, it was found that the most commonly used skills were mainly learned from itinerant and circuit bedside teaching training activities, training camp and video watching. On the whole, participants believed that the training activities of our program really meeting social expectations of professionalism domain of competencies. Moreover, participants learned the most competency instructional skills from OPD teaching and CbD evaluation training activities, and training camp. Finally, PGY1 clinical teachers depend on both 40-hour basal training activities and training camp/video watching to completely establish of their core competence. Conclusions: The results of current study help us to adjust the design of different teaching models of our ”training program for PGY1 clinical teacher” in the future. Meanwhile, we also understand the possibilities for application of skills learning our teaching models by all PGY1 clinical teachers.

並列關鍵字

six-core competencies ； PGY1 clinical teachers ； PGY1 residents

參考文獻

ACGME outcome project. Available at: [http://www.acgmec.org]

Balslev, T,de Grave, WS,Muijtjens, AMM(2005).Comparison of text and video cases in a postgraduate problem-based learning format.Med Educ.39,1086-1092.

Chan, L.K.,Patil, N.G.,Chen, J.Y.(2010).Advantages of video trigger in problem-based learning.Med Teache.32,760-765.

Chan, C.Y.(2009)。The impacts of and methods of coping with the extension of the post-graduate year general medicine training program。J Med Educ。13，226-231。

Harrison, J.P.,Curran, L.(2009).The hospitaist model: Does it enhance health care quality ?.J Health Care Finance.35,22-34.