미래 의사를 위한 교과과정 : 임상의사의 관점에서

미래 의사를 위한 교과과정 : 임상의사의 관점에서

The curriculum for the doctor of the future: Messages from the clinician’s perspective

NADINE VAN DER LEE1, MICHIEL WESTERMAN1, JOANNE P. I. FOKKEMA1,

CEES P. M. VAN DER VLEUTEN2, ALBERT J. J. A. SCHERPBIER2 & FEDDE SCHEELE3

배경

의과대학 교육과정은 의료의 미래에 초점을 맞춰야 한다. CanMEDS나 ACGME나 Tomorrow's doctor와 같은 현재의 역량에 대한 개념(competency framework)은 포괄적인 역량(generic competencies)을 강조해서 이러한 비전을 공유해야 한다.

목적

이 연구의 목적은 현재의 역량에 대한 개념(contemporary competency framework)이 미래의 의료에 대한 임상의사들의 관점과 얼마나 잘 맞는가를 조사하였다.

방법

전략적 계획 접근법(strategic planning approach)을 활용하여, 의사의 미래에 대한 반구조화된 개방형 설문지를 102명의 네덜란드 부인과 의사들에게 보냈다. 유도성 분석(inductive analysis)을 통해서 CanMEDS와 비교하여 미래에 대한 관점과 필요한 역량을 밝히고자 했다.

Answers.com > Wiki Answers > Categories > Uncategorized > What is inductive analysis?

What is inductive analysis?

Answer:

According to Johnson & Christensen (2004) it is "immersion in the details and specifics of the data to discover important patterns, themes, and interrelationships; begins by exploring, then confirming, guided by analytical principles" (p. 362) 

Reference: Johnson B. & Christensen L. (2004). Educational research: Quantitative, qualitative, and mixed approaches (2nd edition). Boston: Pearson Education, Inc.

결과

62명의 응답자들이 CanMEDS roles의 내용적 타당성에 수긍하였다. 추가로 두 가지 역할이 더 드러났는데, advanced technology user and entrepreneur이다. Communicator의 역할은 환자들의 더욱 적극적인 참여를 통해서 변화할 것이다. Collaborator와 Manager의 역할 또한 복잡한 학문간 팀워크와 리더쉽 역할에 따라서 변화할 것이다.

결론

Strategic planning approach을 이용하여 미래에 대한 네덜란드 부인과 의사들의 관점을 확인함으로서 두 가지 추가적인 역할과 기존의 competency framework 내에서 더 집중해야 할 분야가 드러났다. 미래의 의료에 대한 임상의사들의 관점은 어떻게 미래를 보증해줄 수 있는 교과과정을 설계할 것인가에 대한 값진 메시지를 던져준다.

Practice points

. Strategic planning can be used to test how future-proof, a competency framework is.

. For the greater part, the CanMEDS framework is future proof for postgraduate training within the specialty ObGyn.

. The roles ‘‘entrepreneur’’ and ‘‘advanced technology user’’ should be added to competency frameworks.

. ‘‘Role specialization’’ could be a way to master competencies as a group of clinicians.

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Research into a future perspective and adapting current strategies to that perspective is known in business management as strategic planning. In strategic planning, strategies and goals are set for future businesses by considering internal (within the company) and external (outside the company) factors that will impact the future. 

In medical education, strategic planning seems to be focused on ‘‘providing for future workforce’’ (Bennett & Phillips 2010) and future ‘‘overall organization and structure’’ of medical education (Association of Faculties of Medicine of Canada 2009). To our knowledge, a strategic planning approach for future competencies has not previously been described in medical education literature. 

One of the methods for strategic planning in business management includes a three-step approach, the draw-see-think method (Saxena 2009).

First, a vision of what the desired or intended future state will be is identified (draw step). This involves an internal analysis of the firm to get a clear perspective on the desired or intended future state and includes all staff and board members. In medical education, this step could include several stakeholders of which health care providers and patients are the most obvious. This study involved practising medical specialists. They are confronted with changes in the workplace on a daily basis and might be able to provide us with a useful perspective on the future of their workplace and the competencies needed. 

In the second step (see step), the current situation is viewed and compared to the future perspective. In this study, the comparison of the competencies needed for the future workplace to a current competency framework might provide insight on how future proof the framework is.

The final step (think step) identifies what specific actions should be taken to close the gap between today’s situation and the future perspective.

This study takes the draw and see steps in strategic planning for future medical education and considers both the internal and external factors of the medical field that are likely to impact the future. The more detailed think step was considered to be beyond the focus of this study and will be addressed in a future study.

The research objectives are:

Draw step: – What is the vision of clinicians on the future workplace?

See step: – Are contemporary competency frameworks future-proof when compared to the future perspective of clinicians?

In this qualitative study, the opinions of Dutch gynecologists were used to reveal a perspective on the future which was then compared to a contemporary competency framework using a strategic planning approach.

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Analysis

Draw step. The returned questionnaires were categorized into groups, depending on the type of hospital in which the respondent was located (university teaching hospital, general teaching hospital, general hospital, and resident) to be able to compare the perspectives between the respondents. Then, the data were anonymized and imported into a qualitative data analysis software program (MaxQDA 2007). 

In the analysis, the method described by Miles and Huberman (1994) was used, involving three streams of activity (data reduction, data display, and conclusion drawing and verification). 

Data reduction is meant to reduce data into manageable and interpretable pieces. In this study, an open coding strategy was used for data reduction in which a text fragment is represented by a code. A second researcher (MW) also coded two randomly chosen questionnaires from each of the groups. Differences in codes were discussed until consensus was reached.

In the stream of activity of data display, reduced data are organized to be able to draw conclusions from the data. Codes on related subjects were organized into categories. By organizing these categories, ‘‘change themes’’ were defined which were discussed by the research team until consensus was reached. A change theme represents a field in which changes for the future are predicted. 

See step. The future perspective was then compared to a contemporary competency framework. The ObGyn postgraduate training program in the Netherlands uses the Canadian Medical Education Directions for Specialists (CanMEDS) framework from the Royal College of Physicians and Surgeons of Canada (RCPSC), implemented in 2005 (Scheele et al. 2008). Therefore, the research team decided to use this framework in the see step.

For each code within a change theme, relevant competencies were identified (list available on request). Subsequently, these predicted relevant competencies were, when possible, categorized into the seven CanMEDS roles (Medical Expert, Communicator, Collaborator, Health Advocate, Manager, Scholar, and Professional). 

Hereafter, the research team compared the current description of the CanMEDS framework (as published on the website of the RCPSC) to the list of predicted relevant competencies looking for focus areas and potential differences.

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Med Teach. 2011;33(7):555-61. doi: 10.3109/0142159X.2011.578176.

The curriculum for the doctor of the future: messages from the clinician's perspective.

van der Lee N, Westerman M, Fokkema JP, Van Der Vleuten CP, Scherpbier AJ, Scheele F.

Source

St Lucas Andreas Hospital, The Netherlands. n.vanderlee@slaz.nl

Abstract

BACKGROUND:

Medical curricula should focus on the future of health care. Contemporary competency frameworks for curriculum design such as Canadian Medical Education Directions for Specialists (CanMEDS), ACGME and Tomorrow's Doctors share this vision by stressing generic competencies.

AIM:

The objective of this study was to investigate how well a contemporary competency framework fits in with clinicians' perspectives on futurehealth care.

METHODS:

Using a strategic planning approach, a semi-structured open-ended questionnaire on the future of their profession was sent to 102 Dutch gynecologists. Through inductive analysis, a future perspective and its needed competencies were identified and compared to the CanMEDS framework.

RESULTS:

The 62 responses showed content validity for the CanMEDS roles. Additionally, two roles were identified: advanced technology user and entrepreneur. Within the role Communicator, the focus will change through more active patient participation. The roles Collaborator and Manager are predicted to change in focus because of an increase of complex interdisciplinary teamwork and leadership roles.

CONCLUSION:

By studying the Dutch gynecologists' perspective of the future in a strategic planning approach, two additional roles and focus areas within a contemporary competency framework were identified. The perspective of clinicians on future health care provides valuable messages on how to design future-proof curricula.

PMID:

 

21696282

 

[PubMed - indexed for MEDLINE]