A Multisite, Multistakeholder Validation of the Accreditation Council for Graduate Medical Education Competencies

作者：Smith C Scott^*; Morris Magdalena; Francovich Chris; Tivis Rick; Bush Roger; Sanders Shelley Schoepflin; Graham Jeremy; Niven Alex; Kai Mari; Knight Christopher; Hardman Joseph; Caverzagie Kelly; Iobst William

来源：Academic Medicine, 2013, 88(7): 997-1001.

DOI：10.1097/ACM.0b013e3182951efc

Purpose %26lt;br%26gt;The Accreditation Council for Graduate Medical Education%26apos;s (ACGME%26apos;s) six-competency framework has not been validated across multiple stakeholders and sites. The objective of this study was to perform a multisite validation with five stakeholder groups. %26lt;br%26gt;Method %26lt;br%26gt;This was a cross-sectional, observational study carried out from October to December, 2011, in the internal medicine residency continuity clinics of eight internal medicine residency programs in the Pacific Northwest, including a VA, two academic medical centers, a military medical center, and four private hospitals. The authors performed a cultural consensus analysis (CCA) and a convergent-discriminant analysis using previously developed statements based on internal medicine milestones related to the six competencies. Ten participants were included from each of five stakeholder groups: patients, nurses, residents, faculty members, and administrators from each training site (total: 400 participants). %26lt;br%26gt;Results %26lt;br%26gt;Moderate to high agreement and coherence for all groups were observed (CCA eigenvalue ratios ranging from 2.16 to 3.20); however, high differences in ranking order were seen between groups in four of the CCA statements, which may suggest between-group tension in these areas. Analyses revealed excellent construct validity (Z(contrast) score of 5.323, P %26lt; .0001) for the six-competency framework. Average Spearman correlation between same-node statements was 0.012, and between different-node statements it was -0.096. %26lt;br%26gt;Conclusions %26lt;br%26gt;The ACGME%26apos;s six-competency framework has reasonable face and construct validity across multiple stakeholders and sites. Stakeholders appear to share a single mental model of competence in this learning environment. Data patterns suggest possible improvements to the competency-milestone framework.

• 出版日期2013-7