Chief, Research, Milestones Development and Evaluation, Accreditation Council for Graduate Medical Education
Division Chief, General Internal Medicine, National Naval Medical Center
Associate Program Dierctor, Internal Medicine, Yale University
Director of Medical Student Assessment, Yale University
Director, Developing Faculty Competencies in Assessment
Member, International CBME Group
Outcomes-based Medical Education: Impact of a Global Pandemic
This is a time of extraordinary pressure for everyone in health professions education. In spite of the pressures currently being enocuntered in the United States, the U.S. educational community has recognized it is vital to keep the public and society needsfront and center. Many acts of courage have and continued to be witnessed at U.S. academic healthcare centers.
The pandemic has only served to highlight the critical importance of accelerating the movement to an outcomes-based medical educational system. The ACGME recognizes that traditional time-based or volume-based measures may not be fully achievable during this academic year as a result of the disruption caused by the pandemic. As a result, the ACGME is strongly encouraging each program to use the core principles of CBME to make informed decisions about advancement and graduation. The ACGME recognizes that educational experiences may be modified or disrupted through alternative forms of education such as virtual learning, deployment to another clinical rotation or activity (e.g., ICU, ED, wards, telemedicine), or by missing a traditionally required rotation.
The ACGME is encouraging programs to build on the CBME-based principles and activities that have grown over the years. These principle should be used to support an entrustment decision-making process that determines whether a resident or fellow is ready to progress to the next stage in his or her professional careerr. “Entrustment decision-making” focuses on the conscientiousness, trustworthiness, discernment, and competence of the resident or fellow. Entrustment is grounded in the patient and educational outcomes that a graduate can deliver on the Quadruple Aim. The Quadruple Aim simultaneously improves patient experience of care, population health, and health-care provider work life, while lowering per capita cost. The demonstration of conscientiousness, trustworthiness and discernment supports confidence in assessment outcomes.
This session will provide an overview of the key principles being promoted in the U.S. during the pandemic and their implications for future work in assessment.
對從事衛生專業教育的每個人而言，這是個壓力極大的時期。儘管目前美國面臨著巨大的壓力，但美國教育界已體認到維持公眾和社會的需求至關重要。持續見證了許多美國醫學中心的英勇行動。此次疫情突顯了 加速發展成果導向醫學教育的重要性。美國畢業後醫學教育評鑑委員會(ACGME)意識到，由於疫情造成的干擾， 傳統基於時間或基於服務量的評量在本學年可能無法達成。因此，ACGME強烈鼓勵每個計劃使用以勝任能力為導向醫學教育(Competence-Based Medical Education, CBME)的核心原則來決定醫師能否晉升和畢業。ACGME體認，可以通過替代形式的教育例如虛擬學習，輪崗換科（例如，加護病房，急診，病房，遠距醫療）或跳過傳統要求的科別。
多年來ACGME一直在鼓勵發展以勝任能力為導向醫學教育(CBME)的原則和活動。這些原則應用於可信賴之臨床決策，以判斷住院醫師或研究醫師 是否已準備好進入職業生涯的下一個階段。“可信賴之臨床決策”側重於住院醫師或研究醫師的盡責性，可信賴性，辨別力和能力。可信賴基於畢業生可以達到病人和教育 成果的四重目標 。四重目標 同時改善患者的照護體驗，人民的健康和醫療人員的工作，同時降低了人均成本。醫師在盡責性，可信賴性，辨別力和能力的展現，支持評估成效。此次會議將概述在新冠肺炎大流行期間在美國推廣的關鍵原則及其對未來評估工作的影響。