能力評核，精準教學－談臨床能力委員會之推行經驗

自2019年住院醫師納入勞基法後，雖然保障了住院醫師的勞動條件。然而，隨著工時縮減，所衍生出受訓者學習時間減少的問題，不免令人對年輕醫師的臨床能力養成產生質疑。為回應此種疑慮，國內多數專科醫學會已逐步從「以時間為本」（Time-Based）朝向「勝任能力導向的醫學教育」（Competency-Based Medical Education, CBME）發展。「臨床能力委員會」（Clinical Competency Committee, CCC）即是擔負CBME中系統性與計畫性評量的整合與回饋之重要角色，臺北醫學大學附設醫院自2017年起，有計畫的分三階段來逐步推動。首先，住院醫師訓練架構全面接軌美國ACGME之「里程碑計畫」（Milestone Project），以期能將訓練之成效結構化與標準化，並據以做為CCC中評量學員表現的重要參考依據。其次，培育全院CBME種子教師，並積極對各職類臨床教師進行師培認證，確保推動CCC的執行品質。在前述兩階段準備工作完成後，全面設立各層級學員之CCC，以群體智慧的新決策模式來取代行政主管身兼評量大權之舊典範，進而落實在工時減少下，訓練機構所肩負教育稽核之社會責任。

關鍵字

臨床能力委員會；里程碑計畫；勝任能力導向的醫學教育

並列摘要

Taipei Medical University Hospital (TMUH) has implemented the competency-based medical education (CBME) under the following three strategies. First, the ACGME Milestone Projects in all specialties were adopted to our resident training programs for standardizing the outcomes of learning. Second, many resources have been put into faculty development and teacher qualification. Third, clinical competency committees (CCC) were set up to achieve ＂the wisdom of crowds＂ and fulfill the social responsibility of a training center . Although CBME has been enforced among all allied health care professionals and all levels of trainees at TMUH, the current educational achievements are still far from satisfactory. Two amendments are now focused to polish our educational innovation, that is to facilitate the ＂shared mental model＂ and the ＂tailored learning＂. We anticipate that our CBME pathway may encourage other institutions to accomplish the ＂precision education＂ in the 21st Century.

並列關鍵字

Competency-Based Medical Education ； Clinical Competency Committee ； Milestone Project

國際替代計量

能力評核，精準教學－談臨床能力委員會之推行經驗

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