전문직업적 정체성 형성(PIF)를 포함시킨 수정된 밀러의 피라미드 (Acad Med, 2016)
Amending Miller’s Pyramid to Include Professional Identity Formation
Richard L. Cruess, MD, Sylvia R. Cruess, MD, and Yvonne Steinert, PhD
1990 년 George Miller1은 "임상 기술 / 역량 / 성과 평가"라는 제목의 기사를 발표했습니다. 그 영향은 즉각적이었습니다. 1 년당 인용 횟수는 1990 년대 한 자릿수에서 증가하여 2010 년에는 100을 넘어 섰고 그 이후로 매년 100-140 회로 증가했습니다.
In 1990, George Miller1 published an article entitled “The Assessment of Clinical Skills / Competence / Performance.” Its impact was immediate. Citations per year grew from single digits in the 1990s, passing 100 in 2010, and remaining between 100 and 140 per year since then.
Miller1은 원 논문에서 "의사가 전문적인 서비스를 제대로 제공하는 것만큼 복잡한 것은 없고, 따라서 이렇게 복잡한 판단을 내리는 데 필요한 모든 데이터를 한 가지 평가만으로 얻을 수는 없다"라고 말하면서 4단계 피라미드 구조를 프레임 워크로 제안했습니다. 의학적 숙달의 여러 단계를 평가 할 수 있다. 밀러는 교육법과 평가법의 통합이 필요하다는 것을 인정하면서 "교수들은 이 피라미드의 상위에 맞는 교육 방법과 평가 절차를 찾아야한다"고 말했다.
In the original article, Miller1 stated that “no single assessment method can provide all the data required for judgment of anything so complex as the delivery of professional services by a successful physician.” He then proposed a four- part pyramidal structure as a framework within which the multiple levels of mastery over the art and science of medicine could be assessed. Recognizing the necessary integration of teaching and assessment, Miller stated that “faculties should seek both instructional methods and evaluation procedures that fall in the upper reaches of this triangle.”1
우리는 Miller의 기여에 찬사 보내며, 의학 교육에서 전문직 정체성 형성(PIF)의 중요성에 대한 이해가 높아짐에 따라 피라미드의 구성을 재검토해야한다고 제안합니다.
We have nothing but admiration for Miller’s contribution, however, we believe that the growing understanding of the importance of professional identity formation in medical education2–4 suggests that the composition of the pyramid should be reexamined.
잘 알려진 바와 같이 Miller의 피라미드 또는 삼각형 (그림 1)은 지식을 기반으로합니다.
Miller는 전문가의 기능을 수행하는 데 필요한 지식을 개인이 "알고"있다는 지식의 기본 중요성을 인식했습니다. 더욱이, 그는 단순히 의학 지식을 습득하는 것만으로는 충분하지 않으며 지식을 평가하는 것이 상대적으로 쉽다는 것을 이해했습니다.
다음 단계는 졸업생들이 자신의 지식을 어떻게 역량의 지표로 사용할 것인지 "방법을 알아야"한다는 사실을 기반으로했으며 지식의 분석, 해석, 합성 및 적용을 평가하는 방법을 검토했습니다.
세 번째 수준 인 "shows how"는 "수행능력"와 관련이 있으며, 학습자가 감독하고 관찰하는 동안 자신의 지식을 사용할 수 있다는 것을 성과를 통해 입증해야하는 필요성을 나타냅니다. Miller는 이 성취도를 평가하기 위해 새로운 방법을 고안했습니다.
마지막으로, 피라미드의 꼭대기는 학습자가 임상 상황에서 독립적으로 기능 할 수 있는지 여부를 결정하려는 시도 인 동사 "Does"가 차지했습니다. Miller1은 "전문적인 행동에 대한 이 단계의 행동 요소는 정확하게 측정하기가 가장 어렵습니다."라고 했다.
As is well known, Miller’s pyramid, or triangle as he also called it (Figure 1), has knowledge as its base.
Miller recognized the foundational importance of knowledge, that an individual “Knows” what is required to carry out the functions of a professional. Moreover, he understood that merely knowing was insufficient for the practice of medicine, and stated that assessing knowledge was relatively easy.
The next layer was based on the fact that graduates must “Know How” to use their knowledge as an indicator of “competence,” and he reviewed methods of assessing the analysis, interpretation, synthesis, and application of knowledge.
The third level, “Shows How” was related to “performance,” referring to the necessity for learners to demonstrate, through performance, that they are capable of using their knowledge while being supervised and observed. Miller described the then emerging methods designed to assess this level of accomplishment.
Finally, the apex of the pyramid was occupied by the verb “Does,” representing an attempt to determine whether learners are capable of functioning independently in clinical situations. Miller1 stated that “this action component of professional behavior is clearly the most difficult to measure accurately and reliably,” an observation that is still accurate.
CBME는 피라미드의 유용성을 강조했습니다. "Know"에서 "Does"까지의 시퀀스가 여러 분야에서 이정표를 개발하기위한 기초 역할을하기 때문이다.
The move to competency-based education and milestones has emphasized the usefulness of the triangle, as the sequence of descriptors from “Knows” to “Does” serves as the basis for developing milestones in many disciplines.9
Miller가 처음 피라미드를 개념화했을 때, 의사가 지속적으로 지식과 기술을 효과적으로 사용하고, 전문가가 기대하는 행동을 보여줄 수 있다면 충분하고 만족스럽다고 생각했을 것입니다. 이론적으로 의사가 의식적으로, 정해진 방식으로 행동한다면 도달할 수 있다.
When Miller conceptualized his pyramid, it seems likely that most observers would have considered it sufficient and satisfactory if they could ensure that those entering practice would consistently use their knowledge and skills effectively and demonstrate the behaviors expected of a professional. Theoretically, this could be accomplished by practitioners consciously acting in the prescribed ways expected of them.
그러나 Hafferty 등은 과연 이것으로 충분한지 궁금해했다. 필요할 때만 전문적으로 행동하면 되는가? Hafferty2는 "임상 의사 결정을 강조하는 근본적인 불확실성과 의학 실습에 스며드는 모호성은 전문적인 존재를 필요로한다고 말하면서 자신의 질문에 대답했습니다. 어떤 사람이하는 것보다 하나에 최선의 근거가있다. "2)
Hafferty2 and others3,4 wondered whether this is sufficient. Is professional behavior something that is only used when necessary? After asking, “Does it really matter what one believes as long as one acts professionally?” Hafferty2 answered his own question by stating that
"임상적 의사결정의 근본인 불확실성은 그 사람이 '무슨 행동을 하는가'를 넘어서 그 사람이 '어떠한 사람인가'에 기반을 둔 전문가적 정체성을 필요로 한다"
“the fundamental uncertainties that underscore clinical decision making and the ambiguities that permeate medical practice, require a professional presence that is best grounded in what one is rather than what one does.”2
전문직정체성professional identity의 중요성을 믿는 다른 사람들은 "무엇을 하는가"보다 "누구인가"가 전문적인 행동의 일관된 존재를 보여주는 더 확실한 근거임에 동의했다. 따라서 우리는 Miller의 피라미드의 꼭대기가 "Is"(그림 2)라는 추가 레벨로 점령되어야한다고 제안 할 것입니다 (그림 2).
Others, believing in the importance of a professional identity, have agreed, stating that “being” is a sounder basis for the consistent presence of professional behaviors than is “doing.”3,4,12 We would therefore propose that above “Does,” the apex of Miller’s pyramid should be occupied by an added level: “Is” (Figure 2).
From Professionalism to Professional Identity Formation
The word “profession” can be traced to Hellenic Greece, first appearing in the work of Scribonius.13 Through the ages, society and physicians have used the word “professional” to describe medical practitioners. Professional behaviors were expected of physicians, but professionalism was not taught. The “professionalism movement”14 of the past few decades arose because medicine and society believed that medicine’s professionalism was threatened by its own failures and by the evolution of modern health care.15,16 As a result, medicine’s professionalism was analyzed, including its origins and the reasons for its continued existence. Definitions were developed,17 and methods of teaching18 and assessing professionalism6,19 were devised. Some definitions actually emphasize observable behaviors,11,18 as do many methods of assessment. Even though there has been a consistent emphasis on the moral nature of medicine and on the transmission of its values to future practitioners, the emphasis has been on “Does.”
Professional identity as a concept has also had a long existence in medicine. The Aristotelian term “phronesis” is largely descriptive of a professional identity and has come down to us in modified form through the ages.20,21 In 1957, Merton,22 in the introduction to a classic study of the sociology of medical education, stated that it is the function of medical education to
transmit the culture of medicine and … to shape the novice into an effective practitioner of medicine, to give him the best available knowledge and skills, and to provide him with a professional identity so that he comes to think, act, and feel like a physician.
This was followed by two other classic studies by Becker and his colleagues23 and Bosk,24 both of which emphasized the centrality of identity to a physician’s “self.” In spite of the considerable impact of these contributions, professional identity as an educational objective received little attention, although the term was frequently invoked as an aspirational goal.
This lack of attention has been remedied in recent years. The Carnegie Foundation report on the future of medical education brought the issue to the forefront. Its authors stated that “professional identity formation—the development of professional values, actions, and aspirations—should be the backbone of medical education.”25
- 학생들은 유아기부터 개발 된 기존 정체성을 가지고 의대에 입학합니다.
- 그들은 의학의 실천 공동체에 참여하기를 원하고 43), 자신의 전문 분야에 대한 최종적인 강한 감각을 지닌 의대생, 레지던트, 의사의 정체성을 연속적으로 습득합니다 .44
- 그들의 전문직 정체성은 의식적 의사 결정과 임상적 및 비임상적 경험에 총체적으로 영향을 받는다45
- 프로세스 전반에 걸쳐 "완전히 통합 된 도덕적 자아 (개인적 및 전문적 가치가 완전히 통합되고 일관되게 적용되는 것)를 나타내는 정체성을 구축하는 것"이 목표가 된다3
- 바람직한 정체성의 본질은 단일하지도, 정적이지도 않다. 모든 개인은 자신의 삶 전체에서 계속 변화하는 다양한 개인 및 전문직 정체성을 습득합니다.
- 자비로운 의사에 대한 열망과 같은 사회적 기대가 있지만, 사회와 의료 전달 시스템이 발전함에 따라 전문직 정체성의 어떤 측면들은 변화할 것이다. 지난 수십 년간 환자의 자율성에 대한 존중을 점차 강조해 온 것은 그러한 변화를 대표한다.
The nature of the professional identity narrative in medicine is now clear.
Individuals enter medical school with existing identities developed since infancy.
They desire to join the community of practice that is medicine43 and successively acquire the identity of medical student, resident, and practitioner, with a final strong sense of belonging to their chosen specialty.44
Their professional identity is developed gradually in stages as a result of both conscious decisions taken and the impact of the totality of their clinical and nonclinical experiences.45
The aim throughout the process is to construct an identity that represents a “fully integrated moral self (one whose personal and professional values are fully integrated and consistently applied).”3
The nature of the desired identity is neither monolithic nor static. Every individual acquires multiple personal and professional identities that continue to change throughout their lives.
Although there are some societal expectations, such as the desire for a caring and compassionate physician who will listen, that seem to be relatively timeless, other aspects of a professional identity will change as both society and health care delivery systems evolve.3,12 The emergence over past decades of the importance of respect for patient autonomy represents such a change.46
The impact of the literature on this evolving understanding of professional identity formation, with the Carnegie Foundation report being of great consequence,25 has been significant, causing many individuals to reexamine their approach to teaching professionalism. Professional identity formation has been identified as “a necessary foundation for professionalism.”31
the real objective of teaching professionalism has always been to assist students as they develop their own professional identities and that professional identity formation should therefore become a principal objective of medical education.46,47 It thus appears that the original formulation of Miller’s pyramid is incomplete. If the objective of medical education is assisting learners to develop their own professional identities so that their behaviors spring from who they are, then “Does” is not sufficient.
"Does"에서 "Is"로 : 전문가 아이덴티티 평가
From “Does” to “Is”: Assessing Professional Identity
밀러의 의도는 평가 이슈를 다루는 것이었고, 그의 피라미드를 변경해야하는 경우,이 문맥 적 틀을 무시할 수 없었습니다. 수정 된 피라미드 버전이 도움이된다면, "Is."를 포함하여 각 단계에 대하여 평가 방법이 있어야합니다.
Miller’s intent was to address the issue of assessment, and if his pyramid is to be altered, this contextual framework cannot be ignored. If the revised version of the pyramid is to be of assistance, methods of assessment must be available for each level of achievement, including “Is.”
전문직업성의 평가와 PIF에 대한 평가의 목적은 서로 다르며, 서로 다른 방법이 필요합니다. "Does"는 "Is"와 다릅니다.
The assessment of professionalism and of professional identity formation have different objectives and will require different methods. “Does” is different from “Is.”
호킨스와 그의 동료들은 밀러의 피라미드를 효과적으로 사용하여 전문성을 평가하는 "누가, 무엇을, 언제, 어디서, 어떻게 그리고 ... 왜"논의하는 데 효과적으로 사용했습니다. 피라미드의 기초를 놓고
"Knows"은 지식 기반에 "전문성의 핵심 원칙을 알고 이해해야한다"고 기술했다.
"Knows how"의 예로는 "특정한 도덕적 갈등을 다루는 과정을 설명한다.
"Shows how"는 "인터뷰에서 문화적 민감성을 보여 주겠다 "고 제안했고
"Does"는 사람들은"복잡한 의료 시스템에있는 환자를 지지하는 것"을 제안했습니다.
각각에 대해 평가 방법에 대한 개요를 제공합니다.
Hawkins and his colleagues5 used Miller’s pyramid effectively in discussing “who, what, when, where, how, and … why” to assess professionalism.
For the foundation of the pyramid, “Knows,” they stated that the knowledge base should include “Knows/understands core principles of professionalism.”
For “Knows How,” they gave as an example “Describes a process for addressing a specific moral conflict.”
As a representative of “Shows How,” they suggested “Demonstrates cultural sensitivity in interviewing,” and
for “Does” they proposed “Advocates for patients in complex healthcare systems.”
For each, they provide an overview of the methods available at the time for assessment.
그림 2에서 우리는 비슷한 템플릿을 제공하려고 시도했습니다.
"Knows"의 경우 학습자는 "의사가 기대하는 행동 규범을 알게 될 것"이라고 예상 할 수 있습니다. 의학 공동체의 행동 규범은 모든 학습자에게 명시 적으로 전달되어야합니다.
"Knows how"수준에서, "개인 행동이 언제 적절한 것인지를 아는 것"이 필요합니다.이 과정은 커리큘럼에서 명시 적으로 전달되어야합니다.
"Shows how"는 학습자가 감독하에 있는 동안 의사가 기대하는 행동을 보여주는 것이다
"Does"레벨에서, 학습자는 의사가 기대하는 행동을 의식적으로 보여줄 것으로 기대합니다.
마지막으로, 삼각형의 꼭대기에서 개인은 "의사처럼 생각하고 행동하고 느끼기" 때문에 "is"단계에서의 행동이 자연스럽게 일어납니다. 22 이것은 개인의 태도, 가치 및 신념을 포괄합니다.
In Figure 2 we have attempted to provide a similar template .
For “Knows,” learners wouldbe expected to “Know the behavioral norms expected of a physician.” For this to occur, the behavioral norms of medicine’s community of practice must be communicated explicitly to every learner.
At the “Knows How” level, it would be necessary to “Know when individual behaviors are appropriate”—again, something that must be communicated explicitly in the curriculum.
As learners progress up the pyramid, they would model “Shows How” by demonstrating the behaviors expected of a physician while under supervision.
At the “Does” level, the expectation would be that a learner consciously demonstrates the behaviors expected of a physician.
Finally, at the apex of the triangle, behaviors at the “Is” stage would occur naturally because the individual has come to “think, act, and feel like a physician.”22 This would encompass the individual’s attitudes, values, and beliefs.
직업적 정체성을 발전시키고 견고하게하는 결정적 사건 (예 : 죽음과의 최초 접촉)이 있을 수 있고, 따라서 피라미드의 각 단계가 선형적으로 진행되지는 않습니다. 학습 환경이 개인에 대해 서포트해주지 못하면, 발달 과정이 지연될 수 있습니다 .2,32,38
The process does not proceed linearly as there are sentinel occurrences (as an example, the first contact with death) that advance and solidify a professional identity.3,29,30 A learning environment that fails to support individuals during their journey can retard the process.2,32,38
Miller1이 지적한 것처럼 피라미드가 올라감에 따라 평가가 더 복잡해지고 "Is"에 대한 평가가 "Does"평가보다 더 어려울 것입니다. 기본 지식에 대한 평가는 가장 덜 어렵다. 밀러 (Miller)가 지적한 바와 같이, 지식의 존재 유무는 전통적인 방법으로 쉽게 평가할 수 있습니다.
As Miller1 pointed out, assessment becomes more complex as one ascends the pyramid, and the assessment of “Is” will undoubtedly prove to be more difficult than the assessment of “Does.” The base—knowledge—continues to offer the fewest difficulties for assessment. The presence or absence of knowledge can be assessed easily by traditional methods, as noted by Miller.
피라미드를 진행함에 따라 전문성 평가는 '전문적 정체성 형성'이라는 렌즈를 통해 재검토되고 재구성 될 수 있습니다. 기대되는 정체성의 태도, 가치 및 특성이 본질적으로 주관적이어서 직접적으로 평가하기가 어렵기 때문에, '정체성 평가'는 태도, 가치관 및 태도를 보여주는 행동의 관찰에 계속 의존할 것이다. 또한 문제행동과 비전문가 행동은 계속 주의를 요한다.
As one progresses up the pyramid, the assessment of professionalism can be reexamined and reformulated through the lens of professional identity formation. As the attitudes, values, and characteristics of the desired identity are largely subjective in nature, and therefore difficult to assess directly,48 it is probable that there will continue to be a reliance on the observation of behaviors representative of those attitudes, values, and characteristics as a surrogate for the assessment of identity.46 In addition, professional lapses and unprofessional behaviors will continue to require attention.
그러나 관찰 가능한 행동에만 의존한다면, 전문성의 중요한 측면을 놓칠 수 있다.
However, it is recognized that reliance on observable behaviors alone misses important aspects of professionalism,49
지금까지 자신의 발달 상황을 평가하는 도구는 당사자의 해석에 크게 의존하고 있으며, 미래를 긍정적으로 보여주려는 경향이 있다.
The tools that have been developed thus far to have relied heavily onthe interpretation of individuals assessing their own progress, and it seems likely that this will represent a rewarding direction in the future.
각 개별 학습자는 유니크하며, 한 사람도 다수의 전문직 정체성을 보유하기 때문에 평가는 더욱 어렵다. 따라서 교육 목표로서의 단일 표준은 불가능할 뿐만 아니라 바람직하지도 않습니다. Frost와 Regehr39는 의학 교육의 목표는 의학에 입문한 모든 사람들의 정체성을 표준화, 균질화하는 것이 아니라고 지적했다. 그들은 개인적 정체성과 의료계에서의 정체성의 다양성을 유지하는 것이 중요하다는 점을 강조합니다. 정체성에 대한 변화 없이 의사가 되는 것은 불가능하지만, 의대에 입학했을 때의 "자아"가 가진 성격은 지속되어야 합니다.
Assessment is further complicated by the fact that it is axiomatic that each individual learner is unique and each will possess multiple personal and professional identities.3,4,46 Thus, a single standard as an educational objective is not only impossible, it is undesirable. Frost and Regehr39 have pointed out that the objective of medical education is not the homogenization of all individual identities into a standardized medical persona imposed on those entering medicine. They stress the importance of both maintaining an individual’s personal identity and a diversity of identities within the medical profession. Although it is not possible to acquire the identity of a physician without changing one’s identity, the nature of the “self ” that enters medical school must be allowed to persist.
Methods Currently Available to Assess Professional Identity Formation
의학 분야에서 개발된 방법
Methods developed in medicine
자기 인식의 중요성을 강조한 마샤 (Marcia)는 Erikson에 의해 제안 된 신원 개발 단계에 대한 운영상의 정의를 제공하는 "정체성 상태 패러다임"을 개발했다 .52이 구조를 기초로 Niemi26은 질적 방법을 사용하여 "학습 일지"를 분석하고 "정체성 상태 인터뷰". 둘 다 유도 반사에 크게 의존합니다.
Marcia,51 who stressedthe importance of self-perception developed an “identity status paradigm” which provided operational definitions for the stages of identity development proposed by Erikson.52 On the basis of this framework, Niemi26 used qualitative methods to analyze “learning logs” and “identity status interviews,” both of which depend heavily on guided reflection.
그들의 전임상 훈련의 끝에서, 학생들은 네 가지 범주로 균등하게 배분되었다. 여전히 특정 대안을 적극적으로 탐구하는 사람들; 그들의 정체성에 관한 모호한 환상과 잠정적 인 생각을 다루는 사람들; 매우 분산 된 신분 상태를 유지하고있는 사람들.
At the end of their preclinical training, students were evenly distributed between four categories:
those who had achieved a stage-appropriate professional identity;
those still actively exploring specific alternatives;
those dealing with vague fantasies and tentative ideas about their identities; and
those who remained with a very diffuse identity status.
또 다른 관련 도구는 Crossley와 Vivekananda-Schmidt가 개발 한 직업적 정체성 개발에 기여하는 커리큘럼 특징을 조사하기 위해 개발 한 "Professional Self Identity Questionnaire"입니다.
Another relevant tool is the “Professional Self Identity Questionnaire” developed by Crossley and Vivekananda-Schmidt31 to examine the curricular features that contribute to the development of a professional identity.
Madill과 Latchford53은 인간 해부 전후의 1 학년 의대생의 직업적 정체성을 추적하기 위해 2 개의 "레퍼토리 그리드"를 개발했다.
Madill and Latchford53 developed two “repertory grids” to trace the development of professional identity of first-year medical students before and after human dissection.
다른 분야에서 개발된 방법
Methods developed in other professions
치과학 3과 미국 육군 54의 장교들도 다른 분야에서 "Is"를 평가할 가능성을 확인하는 확실한 연구가있었습니다.
There have also been solid studies in dentistry3 and in the officer corps of the U.S. Army54 that confirm the possibility of assessing “Is” in other professions.
Bebeau와 동료들은 치과 학생들에게 전문적인 정체성 개발을 평가했다. Bebeau는 Kegan57에 의해 제안 된 정체성 개발의 6 단계 이론적 틀에 크게 의지합니다.
Bebeau and colleagues55,56 have assessed professional identity development in dental students. Bebeau leans heavily on the six-stage theoretical framework of identity development proposed by Kegan57 that she has adapted for use in dental education.
교육에 대한 함의
The Implications for Teaching
새로운 성취 수준을 평가하려면, 교육에도 변화가 있어야 함은 자명하다. 전문적 정체성 형성은 의학 교육의 목표가되어야하며 전문성의 기초로서의 중요성을 인정해야합니다.
It is self-evident that introducing the assessment of a new level of accomplishment in medical education must be linked to changes in what is taught. Professional identity formation should become a goal of medical education, thus acknowledging its importance as the foundation of professionalism.
전문성의 본질, 그것이 존재하는 이유, 약의 사회 계약과의 연관성, 의학의 전문적 지위를 유지하는 데 필요한 행동에 대한 분명한 가르침은 여전히 중요합니다. 여기에 추가로 전문직 정체성 형성과 사회화 과정을 명시되어야 한다. 이런 식으로 학습자는 자신의 정체성을 개발하고 롤모델과 멘토와 협력하여이 목표를 향한 자신의 발달과정을 추적 할 수 있습니다. 10,47,56 "Is"에 대한 평가는 주로 학생들은 의학의 공동체 실천에 동참합니다. 의사가 실제로 "의사처럼 생각하고 행동하고 느끼는 것"을 보장하기 위해서는, 의학에 대한 사회의 의무를 충족시키기 위해 총괄평가가 필요합니다.
The explicit teaching of the nature of professionalism, the reasons for its existence, its link to medicine’s social contract, and the actions necessary to sustain medicine’s professional status will remain important. To this should be added explicitly outlining the process of professional identity formation and socialization. In this way, learners can become engaged in the development of their own identity, tracing their own progress toward this goal in collaboration with role models and mentors.10,47,56 The assessing of “Is” should be primarily formative in order to guide students as they join medicine’s community of practice. Summative assessment will remain necessary to meet medicine’s obligation to society to ensure that practicing physicians have come to “think, act, and feel like a physician.”22
결론
Conclusion
조지 밀러 (George Miller) 1의 견해를 마무리하는 것이 적절합니다. "임상 실적의 적정성을 증명하기 위해 사회가 제기 한 혐의에 충실해야한다면 ... 더 이상 가능한 방법을 찾을 책임을 피할 수 없습니다.
It is appropriate to close with a quote from George Miller1:
“If we are to be faithful to the charge placed upon us by society to certify the adequacy of clinical performance … then we can no longer evade the responsibility for finding a method that will allow us to do so.”
전문직 정체성 형성은 교육의 목표가 되었고, 이 목표 달성도를 명시적으로 평가하는 것은 우리의 책임이 되었다.
As professional identity formation becomes an educational goal, explicitly assessing progress toward the achievement of this goal becomes a responsibility,
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Acad Med. 2016 Feb;91(2):180-5. doi: 10.1097/ACM.0000000000000913.
Amending Miller's Pyramid to Include Professional Identity Formation.
Author information
- 1
- R.L. Cruess is professor of surgery and core faculty member, Centre for Medical Education of McGill University, Montreal, Quebec, Canada. S.R. Cruess is professor of medicine and core faculty member, Centre for Medical Education of McGill University, Montreal, Quebec, Canada. Y. Steinert is professor of family medicine and director, Centre for Medical Education of McGill University, Montreal, Quebec, Canada.
Abstract
Comment in
- In Reply to Barnhoorn. [Acad Med. 2016]
- Alternative Framings, Countervailing Visions: Locating the "P" in Professional Identity Formation. [Acad Med. 2016]
- Professional Identity Formation: Onions Rather Than Pyramids. [Acad Med. 2016]
- PMID:
- 26332429
- DOI:
- 10.1097/ACM.0000000000000913
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