麻醉專科醫師訓練里程碑計畫成效評量暨甄審筆試測驗分析

Performance Evaluation of the Milestone Program to Residency Training and Test Analysis of the Written Examinations for Certification in Anesthesiology

"隨著社會大眾對醫療保健安全性、有效性及責任性的需求日益提升，專科醫師臨床能力的評量逐漸成為醫學教育關注的重點項目。住院醫師的培訓、評量及專科醫師甄審成為確保醫療品質及醫師臨床能力之關鍵要素。我國麻醉專科醫師在養成訓練中導入核心能力導向醫學教育（Competency-based Medical Education, CBME）里程碑計畫，甄審包含主要的筆試測驗及口試兩部份，正確評量其能力表現成為專科醫師甄審之重要課題。有鑑於此，本研究針對過去（2007~2018）麻醉專科醫師甄審筆試測驗及某醫學中心麻醉部住院醫師訓練里程碑計畫評量（2017~2018）結果進行分析，結果顯示（1）考生甄審筆試測驗成績良好、（2）住院醫師能力表現與訓練目的相符、（3）不同層級住院醫師的里程碑計畫項目能力表現有差異、（4）里程碑計畫評量結果可提供質量兼備之回饋，本研究並提出（1）宜建構多元且可靠之專科醫師甄審機制、（2）宜針對不同層級住院醫師規劃不同訓練重點、（3）宜定期追蹤里程碑計畫評量結果等建議，可做為相關單位改善麻醉專科醫師訓練及甄審之重要參據。"

"With the increasing public demands for safety, effectiveness and responsibility in health care, clinical competency evaluation of medical specialists is becoming an important issue in medical education. Residency training, assessment and certification are essentials to ensure health care quality and competency of medical specialists. Since CBME milestone program has been introduced to residency training in anesthesiology and certification including written tests as the major part and oral tests in our country, correctly evaluating ability of trainees becomes a hot topic in certification of medical specialists. Accordingly, this study analyzed the results of past certification examinations (2007~2018) and assessments of the milestone program for residency training (2017~2018) in anesthesiology in a medical center. It is noted that (1) the examinees performed well in written tests for certification; (2) residents’ ability was consistent with training purposes; (3) there were differences in item performances in the milestone program for residency training; (4) quantitative and qualitative feedbacks could be provided from the evaluation of milestone program. We also suggest that (1) The construction of multiple and reliable evaluation tools for certification in medical specialists is necessary; (2) Preparation of different training focuses for residents in distinct grades is important; (3) Regular follow-up of the evaluation results for milestone programs is essential. Our findings and suggestions could be regarded as references to improve residency training and certification examinations in anesthesiology for those who are concerned."