모든 보건의료직을 위한 역량 영역(Competency domain)에 대한 공통된 분류법, 그리고 의사의 역량(Acad Med, 2013)

모든 보건의료직을 위한 역량 영역(Competency domain)에 대한 공통된 분류법, 그리고 의사의 역량

Toward a Common Taxonomy of Competency Domains for the Health Professions and Competencies for Physicians

Robert Englander, MD, MPH, Terri Cameron, MA, Adrian J. Ballard, Jessica Dodge, Janet Bull, MA, and Carol A. Aschenbrener, MD

공동의 언어를 사용하는 것은 변화를 적응력있게 이끌어나가기 위해서 무척 중요하다. 설령 한 이슈에 대해서 전혀 다른 의견을 가지고 있더라도, 같은 말을 같은 의미로 사용할 때야만이 더 효과적으로 의사소통을 할 수 있고, 오해를 줄일 수 있으며, 같은 위치에 있다고 느낄 수 있다.

Shared language is important in leading adaptive change. When people begin to use the same words with the same meaning, they communicate more effectively, minimize misunderstandings, and gain the sense of being on the same page, even while grappling with significant differences on the issues.49(p9)

"Heifetz R, Linsky M, Grashow A. The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World. Boston, Mass: Cambridge Leadership Associates; 2009."

'역량바탕 의학교육'으로 패러다임이 변화한 것은 의학교육시스템이 만들어내는 의사에 대한 대중에 요구에 의해 적응력있는 변화(adaptive change)을 보여준다. 여기에 한 가지 장애물은 의료인력의 '역량의 영역(domains of competence)'를 정의하는 공동의 언어와 의사가 만들어지고 지속적으로 성정하는데 중요한 구체적인 역량에 대한 정의가 없었다는 점이다.

The paradigm shift to competency-based medical education represents an adaptive change driven by public demands for increased accountability for the physicians the medical education system produces.1 One of the barriers to implementation has been the lack of a common language describing domains of competence in the health professions and the specific competencies that are critical to the formation and continuing development of physicians.

Definitions of Key Concepts

• Competency framework: 

“An organized and structured representation of a set of interrelated and purposeful competencies.”14

• Domains of competence: Broad distinguishable areas of competence that in the aggregate constitute a general descriptive framework for a profession. (Authors’ definition)

• Competency list: The delineation of the specific competencies within a competency framework. (Authors’ definition)

• Competence: 

“The array of abilities [knowledge, skills, and attitudes, or KSA] across multiple domains or aspects of performance in a certain context. 

Statements about competence require descriptive qualifiers to define the relevant abilities, context, and stage of training. 

Competence is multi-dimensional and dynamic. It changes with time, experience, and setting.”15

• Competency: 

“An observable ability of a health professional, integrating multiple components such as knowledge, skills, values, and attitudes. 

Since competencies are observable, they can be measured and assessed to ensure their acquisition.”15

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1. Patient Care

Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

2. Knowledge for Practice§

Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care

3. Practice-Based Learning and Improvement

Demonstrate the ability to investigate and evaluate one’s care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning

4. Interpersonal and Communication Skills

Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals

5. Professionalism

Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles

6. Systems-Based Practice

Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care

7. Interprofessional Collaboration

Demonstrate the ability to engage in an interprofessional team in a manner that optimizes safe, effective patient- and population-centered care

8. Personal and Professional Development

Demonstrate the qualities required to sustain lifelong personal and professional growth

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Acad Med. 2013 Aug;88(8):1088-1094.

Toward a Common Taxonomy of Competency Domains for the Health Professions and Competencies forPhysicians.

Englander R, Cameron T, Ballard AJ, Dodge J, Bull J, Aschenbrener CA.

Source

Dr. Englander is senior director, Competency-based Learning and Assessment, Association of American Medical Colleges, Washington, DC. Ms. Cameron is director, Curriculum Management, Association of American Medical Colleges, Washington, DC. Mr. Ballard is educational content specialist, Association of American Medical Colleges, Washington, DC. Ms. Dodge is a second-year medical student, University of Connecticut School of Medicine, Farmington, Connecticut. Ms. Bull is lead specialist, Competency-based Learning and Assessment, Association of American Medical Colleges, Washington, DC. Dr. Aschenbrener is chief medical education officer, Association of American Medical Colleges, Washington, DC.

Abstract

Although health professions worldwide are shifting to competency-based education, no common taxonomy for domains of competence and specificcompetencies currently exists. In this article, the authors describe their work to (1) identify domains of competence that could accommodate anyhealth care profession and (2) extract a common set of competencies for physicians from existing health professions' competency frameworks that would be robust enough to provide a single, relevant infrastructure for curricular resources in the Association of American Medical Colleges' (AAMC's) MedEdPORTAL and Curriculum Inventory and Reports (CIR) sites.The authors used the Accreditation Council for Graduate Medical Education (ACGME)/American Board of Medical Specialties six domains of competence and 36 competencies delineated by the ACGME as their foundational reference list. They added two domains described by other groups after the original six domains were introduced: Interprofessional Collaboration (4competencies) and Personal and Professional Development (8 competencies). They compared the expanded reference list (48 competencies within eight domains) with 153 competency lists from across the medical education continuum, physician specialties and subspecialties, countries, andhealth care professions. Comparison analysis led them to add 13 "new" competencies and to conflate 6 competencies into 3 to eliminate redundancy.The AAMC will use the resulting "Reference List of General Physician Competencies" (58 competencies in eight domains) to categorize resources for MedEdPORTAL and CIR. The authors hope that researchers and educators within medicine and other health professions will consider using this reference list when applicable to move toward a common taxonomy of competencies.

PMID:

 

23807109

 

[PubMed - as supplied by publisher]