臨床研修 家庭医療　｜　北海道家庭医療学センター

【文献名】

Baglia J et al. Generating developmentally appropriate competency assessment at a family medicine residency. Fam Med. 2011 Feb;43(2):90-8.

【要約】

＜BACKGROUND AND OBJECTIVE＞

Ten years after the Accreditation Council for Graduate Medical Education's (ACGME) mandate that residency programs evaluate learners' competency, research is needed to guide efforts to meet this challenge. During an innovative residency redesign, the authors developed a process to effectively measure "competence." This particular family medicine residency admits six residents per class year and is sponsored by an academic community hospital. Our objective was to generate developmentally appropriate observable behaviors that assess competencies.

＜METHODS＞

Eight steps guided the development of this assessment system: 

(1) Generate residency-specific competencies, 

1. Relationship-centered care,

2. comprehensive care,

3. information literacy and knowledge creation,

4. leadership and change management, 

5. community health partnership, 

6. lifelong learning, and 

7. self care.

(2) Define residency-specific competencies, 

(3) Identify principles of assessment, 

1. direct observation is ideal and includes both assessment and feedback, 

2. multiple methods are appropriate,

3. assessment is consistent to the extent that visible behaviors are identified, and variations of interpretation are minimized, 

4. assessment and feedback are timely and expected, and 

5. effective assessment practices are dependent upon ongoing faculty development.

(4) Compose and analyze narratives of excellence within each competency, 

(5) Distill standard statements from narratives and organize into Dreyfus levels of competence, 

(6) Derive observable behaviors from standard statements to directly correlate behaviors and competency levels,

(7) Design assessment tools (based on observable behaviors) for six residency learning sites, and