儿科住院医师项目规模与无监督实习准备之间的关系。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-03-08 DOI:10.1016/j.acap.2025.102806

Daniel J. Schumacher MD, PhD, MEd , Ariel S. Winn MD , Joni Hemond MD , Carol Lynn O’Dea MD , Karla L. Garcia MD , Ann E. Burke MD, MBA , Monique M. Naifeh MD, MPH , Jason Zurawick MD , Benjamin Kinnear MD, MEd , Catherine Michelson MD, MMSc , David A. Turner MD , Abigail Martini MSMEd , Alan Schwartz PhD, JD , for the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) Crosswalk Study Group

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引用次数: 0

摘要

目的：本研究试图确定基于住院医师项目规模的项目报告的可委托专业活动（EPA）委托监督水平的差异。方法：在2021-22学年、2022-23学年和2023-24学年结束时，由48个儿科住院医师毕业临床能力委员会确定17个普通儿科EPAs的委托监督水平。程序被分为小型、中型、大型和超大型。作者拟合了一个主效应混合效应逻辑回归模型来预测毕业居民在没有监督的情况下被认为准备好执行每个EPA的可能性，其中计划规模和EPA为固定效应，计划为随机效应。第二个模型也包括计划规模和EPA之间的相互作用作为预测因子。结果：2285名儿科住院医师毕业共报告委托监管等级33335个。与多个规模较大的项目组相比，小型项目更有可能报告住院医生准备好进行无监督的实践，以进行4项EPAs（健康筛查、新生儿健康、识别/转诊手术问题和管理信息）。结论：小项目的特点可能导致他们更倾向于委托即将毕业的住院医师在某些领域进行无监督的实习。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Associations Between Residency Program Size and Readiness for Unsupervised Practice in Pediatrics

Objective

This study sought to determine differences in program-reported entrustable professional activity (EPA) entrustment-supervision levels based on residency program size.

Methods

At the end of the 2021 to 2022, 2022 to 2023, and 2023 to 2024 academic years, entrustment-supervision levels for the 17 General Pediatrics EPAs were determined by clinical competency committees for graduating pediatric residents at 48 pediatrics residency programs. Programs were categorized as small, medium, large, and very large. The authors fitted a main-effects mixed-effects logistic regression model to predict the likelihood that a graduating resident was deemed ready to execute each EPA without supervision, with program size and EPA as fixed effects and program as a random effect. A second model also included the interaction between program size and EPA as a predictor.

Results

A total of 33,335 entrustment-supervision levels were reported for 2285 graduating pediatrics residents. Small programs were more likely to report residents as ready for unsupervised practice than multiple larger-sized program groups for 4 EPAs (health screening, well newborn, recognize/refer surgical problems, and manage information).

Conclusions

Characteristics of small programs may lead them to be more likely to entrust graduating residents with unsupervised practice in certain areas.

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.