建構能力導向訓練計畫之評估架構——修正式德菲法研究

Developing an evaluation framework for competency-based training programs using a modified Delphi method

目標：在台灣發展「能力導向訓練計畫之評估架構」以利能力導向醫學教育之實踐。方法：本研究團隊依據「美國畢業後醫學教育評鑑委員會」訓練計畫指引，並參考國內112年度醫院評鑑及教學醫院評鑑基準、衛福部住院醫師審議委員會評鑑、衛福部二年期醫師畢業後一般醫學訓練計畫等文件，並採用邏輯模型來發展「能力導向訓練計畫之評估架構」之初稿。本研究團隊利用修正式德菲法，蒐集國內23位醫學教育專家之建議。每次調查後，針對各項指標的適切性和一致性進行分析，並依專家意見修正和調整指標內容。結果：能力導向訓練計畫之評估架構之發展涵蓋：計畫書排版與格式、訓練目標與架構、教學師資、教學資源、臨床學習環境、醫學與專業能力訓練方式、全人照護能力訓練方式、考評機制與反映管道、輔導與補強機制和其他等十構面56項細項指標。結論：本研究建構能力導向訓練計畫之評估架構，並透過多機構專家形成共識，此評估架構之分享，旨在協助機構內的計畫評估，以利於能力導向醫學教育之推展與實踐。

Objectives: This study developed an evaluation framework for competency-based training programs to support the implementation of competency-based medical education (CBME) in Taiwan. Methods: Our research team used the logic model to draft an evaluation framework for training programs that align with the Accreditation Council for Graduate Medical Education’s Program Director Guide to Common Program Requirements in the United States. In addition, we referenced various documents, including the 112th-year hospital and teaching hospital accreditation standards in Taiwan, evaluations from the Ministry of Health and Welfare’s Residency Review Committee, and guidelines from the Ministry of Health and Welfare’s General Medical Training Program for Physicians after graduation. This study collected opinions from 23 domestic medical education experts by using the modified Delphi method. After each survey, the appropriateness and consistency of each indicator were evaluated. These indicators were then revised and refined in accordance with feedback from the expert panelists. Results: The evaluation framework for competency-based training programs comprises the following 10 dimensions including a total of 56 indicators:“Project Proposal Layout and Format,”“Training Objectives and Framework,”“Faculty,”“Educational Resources,”“Clinical Learning Environment,”“Medical and Professional Skills Training Approaches,”“Holistic Care Training Approaches,”“Assessment and Feedback Channels,”“Counseling and Remediation Pathways,”and“Others.”Conclusions: The study developed an evaluation framework for competency-based training programs, reaching a consensus with expert panelists from various institutions. This evaluation framework can enhance program evaluations within institutions, thereby facilitating the advancement and implementation of CBME.