Health informatics competencies in postgraduate medical education and training in the UK: a mixed methods study
Health informatics competencies in postgraduate medical education and training in the UK: a mixed methods study
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DOI：
10.1136/bmjopen-2018-025460
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Banerjee, Amitava
中科院分区：
文献类型：
--
作者：
Jidkov, Lydia;Alexander, Matthew;Banerjee, Amitava
目的根据英国数字健康倡议（如英国健康数据研究、国家卫生服务数字学院和全球数字范例）的国际标准，评估英国研究生医学教育中所有专业的健康信息学（HI）培训。设计一项针对国际HI标准的英国研究生临床医生培训课程（71个专业）的混合方法研究：范围审查、课程内容分析和专家咨询。背景和参与者一项范围文献综述（PubMed截止至2017年3月）为医生HI能力域的当代框架的发展提供了信息。从联合王国医学总委员会获得71个研究生医学专业的国家培训课程，并对其进行分析。就调查结果咨询了7位英国HI专家。结果国际医学信息学协会（IMIA）关于生物医学和健康信息学教育的建议被用于开发能力域框架。调查了71个英国研究生医学专业中每个专业所包含的HI能力领域的数量（最多50个）。经过专家评审，提出了一个通用的高智商胜任力框架。结果通过范围评估、课程内容分析和专家咨询，采用21门课程构建了50个高智商能力域框架。所有71个英国研究生医学课程文件被映射到50个框架领域中的29个；也就是说，21个域名没有被表示。课程在50个领域（中位数=7）中的0个（儿童和青少年精神病学和核心外科培训）和16个（化学病理学和儿科和围产期病理学）之间绘制。专家咨询发现，HI能力应该是普遍的，并与英国临床医生的现有能力相结合，在目前的课程中代表性不足。此外，还确定了其他普遍的卫生保健能力，包括信息治理和安全性以及数据的二次使用。结论：英国的研究生医学教育忽视了国际标准所规定的HI能力。迫切需要将关键的医疗保健能力纳入培训课程，为医生在日益数字化的医疗保健环境中工作做好准备。
Objective To assess health informatics (HI) training in UK postgraduate medical education, across all specialties, against international standards in the context of UK digital health initiatives (eg, Health Data Research UK, National Health Service Digital Academy and Global Digital Exemplars).Design A mixed methods study of UK postgraduate clinician training curricula (71 specialties) against international HI standards: scoping review, curricular content analysis and expert consultation.Setting and participants A scoping literature review (PubMed until March 2017) informed development of a contemporary framework of HI competency domains for doctors. National training curricula for 71 postgraduate medical specialties were obtained from the UK General Medical Council and were analysed. Seven UK HI experts were consulted regarding findings.Outcomes The International Medical Informatics Association (IMIA) Recommendations for Biomedical and Health Informatics Education were used to develop a framework of competency domains. The number (maximum 50) of HI competency domains included in each of the 71 UK postgraduate medical specialties was investigated. After expert review, a universal HI competency framework was proposed.Results A framework of 50 HI competency domains was developed using 21 curricula from a scoping review, curricular content analysis and expert consultation. All 71 UK postgraduate medical curricula documents were mapped across 29 of 50 framework domains; that is, 21 domains were unrepresented. Curricula mapped between 0 (child and adolescent psychiatry and core surgical training) and 16 (chemical pathology and paediatric and perinatal pathology) of the 50 domains (median=7). Expert consultation found that HI competencies should be universal and integrated with existing competencies for UK clinicians and were under-represented in current curricula. Additional universal HI competencies were identified, including information governance and security and secondary use of data.Conclusions Postgraduate medical education in the UK neglects HI competencies set out by international standards. Key HI competencies need to be urgently integrated into training curricula to prepare doctors for work in increasingly digitised healthcare environments.