台灣婦產科醫學會里程碑建置經驗分享

Developing and Implementing a Milestone System: Experience of the Taiwan Association of Obstetrics and Gynecology

台灣婦產科醫學會於1961年成立，1987年度辦理第一屆專科醫師考試，建立四年專科訓練規範。由於畢業後一般醫學訓練亦可抵扣專科醫師訓練資格，加上住院醫師工時規範，恐影響住院醫師訓練，故自2017年底開始規劃里程碑制度。參考美國畢業後醫學教育評鑑委員會(Accreditation Council for Graduate Medical Education, ACGME)及美國婦產科醫學會(americancollege of obstetricians and gynecologists, ACOG)聯合修訂、發表訓練內容，完成台灣婦產科醫學會住院醫師訓練里程碑初版，內容依照六大核心能力建立28項勝任能力5個層級。然而2023年透過線性回歸統計方式分析專科醫師考試成績與里程碑分數，發現兩者無顯著相關性。未來將透過即時分析，回饋各醫院，盼透過同儕比較，改善跨院際評核不一致現象，在執行面上，希望導入電子化表單，建立學生的學習歷程及分析。

 

The Taiwan Association of Obstetrics and Gynecology(TAOG)was established in 1961 and conducted its first board certification examination in 1987, formally establishing a structured 4-year training program for Taiwanese specialists.To provide postgraduate general medical training, which could be credited toward specialist training qualifications, and address challenges introduced by resident work-hour regulations, the TAOG subsequently developed a milestone-based evaluation system for residents. On the basis of training content collaboratively revised and published by the Accreditation Council for Graduate Medical Education and the American College of Obstetricians and Gynecologists, the TAOG produced the first version of its residency milestone framework in late 2017. This framework comprised6 core competencies segmented into 28 key competencies across five proficiency levels. Nevertheless, the results of a linear regression conducted in 2023 revealed no significant correlation between milestone scores and specialist examination results. In response, the TAOG will provide feedback to training hospitals,using peer comparisons to address discrepancies in interhospital evaluations. Additionally, the TAOG will implement electronic forms to streamline the documentation and analysis of residents’ learning progress.