Assessing the Transition of Training in Health Systems Science From Undergraduate to Graduate Medical Education.

Accreditation Child Clinical Competence Education, Medical, Graduate Educational Measurement Humans Internship and Residency United States

Journal

Journal of graduate medical education
ISSN: 1949-8357
Titre abrégé: J Grad Med Educ
Pays: United States
ID NLM: 101521733

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 23 10 2020
revised: 17 02 2021
revised: 26 03 2021
accepted: 29 03 2021
entrez: 28 6 2021
pubmed: 29 6 2021
medline: 29 7 2021
Statut: ppublish

Résumé

The American Medical Association Accelerating Change in Medical Education (AMA-ACE) consortium proposes that medical schools include a new 3-pillar model incorporating health systems science (HSS) and basic and clinical sciences. One of the goals of AMA-ACE was to support HSS curricular innovation to improve residency preparation. This study evaluates the effectiveness of HSS curricula by using a large dataset to link medical school graduates to internship Milestones through collaboration with the Accreditation Council for Graduate Medical Education (ACGME). ACGME subcompetencies related to the schools' HSS curricula were identified for internal medicine, emergency medicine, family medicine, obstetrics and gynecology (OB/GYN), pediatrics, and surgery. Analysis compared Milestone ratings of ACE school graduates to non-ACE graduates at 6 and 12 months using generalized estimating equation models. At 6 months both groups demonstrated similar HSS-related levels of Milestone performance on the selected ACGME competencies. At 1 year, ACE graduates in OB/GYN scored minimally higher on 2 systems-based practice (SBP) subcompetencies compared to non-ACE school graduates: SBP01 (1.96 vs 1.82, 95% CI 0.03-0.24) and SBP02 (1.87 vs 1.79, 95% CI 0.01-0.16). In internal medicine, ACE graduates scored minimally higher on 3 HSS-related subcompetencies: SBP01 (2.19 vs 2.05, 95% CI 0.04-0.26), PBLI01 (2.13 vs 2.01; 95% CI 0.01-0.24), and PBLI04 (2.05 vs 1.93; 95% CI 0.03-0.21). For the other specialties examined, there were no significant differences between groups. Graduates from schools with training in HSS had similar Milestone ratings for most subcompetencies and very small differences in Milestone ratings for only 5 subcompetencies across 6 specialties at 1 year, compared to graduates from non-ACE schools. These differences are likely not educationally meaningful.

Sections du résumé

BACKGROUND BACKGROUND
The American Medical Association Accelerating Change in Medical Education (AMA-ACE) consortium proposes that medical schools include a new 3-pillar model incorporating health systems science (HSS) and basic and clinical sciences. One of the goals of AMA-ACE was to support HSS curricular innovation to improve residency preparation.
OBJECTIVE OBJECTIVE
This study evaluates the effectiveness of HSS curricula by using a large dataset to link medical school graduates to internship Milestones through collaboration with the Accreditation Council for Graduate Medical Education (ACGME).
METHODS METHODS
ACGME subcompetencies related to the schools' HSS curricula were identified for internal medicine, emergency medicine, family medicine, obstetrics and gynecology (OB/GYN), pediatrics, and surgery. Analysis compared Milestone ratings of ACE school graduates to non-ACE graduates at 6 and 12 months using generalized estimating equation models.
RESULTS RESULTS
At 6 months both groups demonstrated similar HSS-related levels of Milestone performance on the selected ACGME competencies. At 1 year, ACE graduates in OB/GYN scored minimally higher on 2 systems-based practice (SBP) subcompetencies compared to non-ACE school graduates: SBP01 (1.96 vs 1.82, 95% CI 0.03-0.24) and SBP02 (1.87 vs 1.79, 95% CI 0.01-0.16). In internal medicine, ACE graduates scored minimally higher on 3 HSS-related subcompetencies: SBP01 (2.19 vs 2.05, 95% CI 0.04-0.26), PBLI01 (2.13 vs 2.01; 95% CI 0.01-0.24), and PBLI04 (2.05 vs 1.93; 95% CI 0.03-0.21). For the other specialties examined, there were no significant differences between groups.
CONCLUSIONS CONCLUSIONS
Graduates from schools with training in HSS had similar Milestone ratings for most subcompetencies and very small differences in Milestone ratings for only 5 subcompetencies across 6 specialties at 1 year, compared to graduates from non-ACE schools. These differences are likely not educationally meaningful.

Identifiants

DOI: 10.4300/JGME-D-20-01268.1 PMID: 34178266 PMC: PMC8207938
pubmed: 34178266
doi: 10.4300/JGME-D-20-01268.1
pmc: PMC8207938
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

404-410

Déclaration de conflit d'intérêts

Conflict of interest: The authors declare they have no competing interests.

Références

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Auteurs

Sally A Santen (SA)

is Evaluation Consultant, American Medical Association, and Senior Associate Dean and Professor of Emergency Medicine, Virginia Commonwealth University School of Medicine.

Stanley J Hamstra (SJ)

At the time of writing, was Vice President, Milestones Research and Evaluation, Accreditation Council for Graduate Medical Education (ACGME), and is now Professor, Department of Surgery, University of Toronto, Adjunct Professor, Department of Medical Education, Feinberg School of Medicine, Northwestern University, and Research Consultant, ACGME.

Kenji Yamazaki (K)

, is Senior Analyst, Milestones Research and Evaluation, ACGME.

Jed Gonzalo (J)

is Associate Professor of Medicine and Public Health Science, and Associate Dean for Health Systems Education, Penn State College of Medicine; at the time of writing.

Kim Lomis (K)

was Associate Dean, Vanderbilt University School of Medicine, and is now Vice President, UME Innovations, American Medical Association.

Bradley Allen (B)

is Senior Associate Dean for Medical Student Education and Associate Professor of Clinical Infectious Diseases, Indiana University School of Medicine.

Luan Lawson (L)

is Associate Dean for Curricular Innovation in Medical Education and Associate Professor of Emergency Medicine, Brody School of Medicine at East Carolina University.

Eric S Holmboe (ES)

is Chief Research, Milestone Development, and Evaluation Officer, ACGME.

Marc Triola (M)

is Associate Dean for Educational Informatics and Director of the Institute for Innovations in Medical Education, NYU Grossman School of Medicine.

Paul George (P)

is Associate Professor of Family Medicine and Associate Dean of Medical Education, Warren Alpert Medical School of Brown University.

Paul N Gorman (PN)

is Professor of Medical Informatics and Clinical Epidemiology, Professor of Medicine, and Assistant Dean, Rural Medical Education, School of Medicine, Oregon Health & Science University.

Susan Skochelak (S)

is Group Vice President, Medical Education, American Medical Association.

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Classifications MeSH

questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Assurance de la qualité des soins de santé › Délivrance de titres et certificats › Agrément › Assessing the Transition of Training in Health...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Assessing the Transition of Training in Health...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Compétence clinique › Assessing the Transition of Training in Health...
questionsmedicales.fr › Éducation › Enseignement professionnel › Enseignement médical › Enseignement spécialisé en médecine › Assessing the Transition of Training in Health...
questionsmedicales.fr › Éducation › Évaluation des acquis scolaires › Assessing the Transition of Training in Health...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Assessing the Transition of Training in Health...
questionsmedicales.fr › Éducation › Enseignement professionnel › Enseignement médical › Enseignement spécialisé en médecine › Internat et résidence › Assessing the Transition of Training in Health...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › États-Unis › Assessing the Transition of Training in Health...