Ownership of patient care: a behavioural definition and stepwise approach to diagnosing problems in trainees.
Ownership of patient care: a behavioural definition and stepwise approach to diagnosing problems in trainees.
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DOI：
10.1007/s40037-013-0058-z
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发表时间：
2013-04
影响因子：
3.6
通讯作者：
Cowley, Deborah S
中科院分区：
文献类型：
--
作者：
McLaren, Kimberly;Lord, Julie;Murray, Suzanne B;Levy, Mitchell;Ciechanowski, Paul;Markman, Jesse;Ratzliff, Anna;Grodesky, Michael;Cowley, Deborah S
在医学教育中，行为定义可以进行更有效的评估和监督。患者护理的所有权是学员发展的一个复杂领域，跨越多个评估领域，并且可能缺乏明确的行为定义。为了界定教育目的的所有权，作者对精神病学教学教师和学员进行了调查，了解表明医生表现出对患者护理的所有权的行为。在这项定性描述性研究中，通过分析叙事反应来确定新出现的主题。 41 名教师 (54%) 和 29 名学员 (52%) 做出了回应。教师和学员都确定了所有权的七个核心要素：倡导、自主、承诺、沟通、后续行动、知识和团队合作。这七个要素提供了一个共识衍生的行为定义，可用于确定能力或识别缺陷。拟议的两步流程使监管者能够识别有问题的所有权行为，并确定是否存在知识、技能或态度缺陷。此外，计划行为理论被用来更好地理解态度、意图和后续行为之间的关系。通过构建对患者护理所有权问题的诊断，主管能够在自然环境中提供可行的反馈和干预。提供了三个例子来说明这个逐步过程。
In medical education, behavioural definitions allow for more effective evaluation and supervision. Ownership of patient care is a complex area of trainee development that crosses multiple areas of evaluation and may lack clear behavioural definitions. In an effort to define ownership for educational purposes, the authors surveyed psychiatry teaching faculty and trainees about behaviours that would indicate that a physician is demonstrating ownership of patient care. Emerging themes were identified through analysis of narrative responses in this qualitative descriptive study. Forty-one faculty (54 %) and 29 trainees (52 %) responded. Both faculty and trainees identified seven core elements of ownership: advocacy, autonomy, commitment, communication, follow-through, knowledge and teamwork. These seven elements provide a consensus-derived behavioural definition that can be used to determine competency or identify deficits. The proposed two-step process enables supervisors to identify problematic ownership behaviours and determine whether there is a deficit of knowledge, skill or attitude. Further, the theory of planned behaviour is applied to better understand the relationship between attitudes, intentions and subsequent behaviour. By structuring the diagnosis of problems with ownership of patient care, supervisors are able to provide actionable feedback and intervention in a naturalistic setting. Three examples are presented to illustrate this stepwise process.