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首页> 外文期刊>Academic Medicine: Journal of the Association of American Medical Colleges >What Can the Giant Do? Defining the Path to Unsupervised Primary Care Practice by Competence, Not Time
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What Can the Giant Do? Defining the Path to Unsupervised Primary Care Practice by Competence, Not Time

机译：巨人可以做什么？ 通过能力定义无监督初级保健实践的路径，而不是时间

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摘要

In this issue of Academic Medicine, Dewan and Norcini examine the significant variability of time-in-training between patient care "giants"-the physicians, nurse practitioners, and physician assistants who practice primary care-and they call for further studies to determine optimal training duration and eventual scope of practice. They ask, what is the minimum education and training required to practice primary care, or "how tall is the shortest giant?" In this Invited Commentary, the authors reframe the question from identifying the minimum length of training required, to identifying desired patient care outcomes. Primary care is not a uniform entity. It ranges from complex elderly chronically ill patients, to twentysomething millennials with acute problems, to pregnant women, to families, and everything in between. The authors argue that training should be fit for purpose and produce high-quality outcomes for patients. Competence should be defined by these outcomes. Drawing parallels with Major League Baseball, the authors note that time to competence development will be variable for different training programs depending on purpose, and also variable for people within those programs, even with shared purpose. While time is a tool for competence attainment, it should not be the metric by which readiness for practice is measured.
机译：在这个问题中，德湾和诺尔威尼研究了患者护理“巨头” - 医生，护士从业者和医生助理在练习初级保健的医生 - 以及他们呼吁进一步研究以确定最佳研究的重要变化培训持续时间和最终的实践范围。他们问，练习初级保健所需的最低教育和培训是什么，或者“最短的巨人有多高？”在这邀请的评论中，作者将重新确定所需的最低培训长度，以确定所需的患者护理结果。初级保健不是统一的实体。它根据复杂的老年人长期生病的患者，以Twentysomething千禧一代与急性问题，孕妇，对家庭和之间的一切。作者认为，培训应该适合目的，为患者提供高质量的结果。能力应由这些结果定义。与主要联盟棒球相似，作者注意到能够为不同培训计划的竞争力发展时，根据目的，对于这些计划中的人员而言，也是可变的，即使是共享目的。虽然时间是能力成就的工具，但它不应该是测量实践准备的公制。

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