Competency Matrix for Medical Residency Programmes in Endocrinology and Metabolism

ABSTRACT Introduction Medical competencies have become the focus of Medical Education at all levels around the world. In this context the Medical Residency Programs (MRP) in Brazil have begun to seek a competency-based curriculum to improve the specialist training. Objective To develop a proposed Competency Matrix for Medical Residency Programs in Endocrinology and Metabolism (MREM). Methodology The study was divided into four phases. The first phase consisted of a bibliographical review and construction of the Pilot Matrix. In the second phase the Pilot Matrix was applied to endocrinologists from Belém, with subsequent data analysis and construction of the Structured Matrix. The third phase started with the implementation of the Structured Matrix at the Brazilian Congress of Endocrinology and Metabolism – CBEM 2016 with a total of 49 responses. Based on the Delphi methodology, the 230 competencies of each one of the matrices were analyzed and a questionnaire containing competences with a discrepancy level greater than 10% was created, including some suggestions from the experts. In the fourth and last phase, also using Delphi methodology, the questionnaire was sent by email and data analysis and construction of the MREM proposal was performed. Results In the second, third and fourth phases, the response rate of Endocrinologists was 73.3%, 51% and 76.4%, respectively. With the Southeast region of Brazil presenting the largest number of participants. There are 219 competencies in the Pilot Matrix, 230 in the Structured Matrix and 244 in the final MREM proposal. The competency areas of Diabetes and Obesity, Metabolic Syndrome and Alterations of Appetite were those which showed major change and suggestions. In all phases, only 2 competencies were excluded. The suggestions made in the third phase were unanimously accepted. Conclusion The MREM proposal was concluded with 21 areas and 244 competencies, 33 classified as prerequisites, 157 as essential competencies, 36 as desirable and 18 as advanced. The competencies were distributed as follows in the MCPRMEM: “Fundamental” field with 100 competencies, with 15 prerequisites, 65 core competencies, 14 desirable and 6 advanced ones; “Specific Knowledge” field with 132 competences, with 18 prerequisites, 87 essential competences, 19 desirable and 8 advanced; and “Complementary Training” field with 12 skills, no prerequisites, 5 core competencies, 3 desirable and 4 advanced skills.

摘要
引言 医学胜任力已成为全球各级医学教育的核心关注方向。在此背景下，巴西的住院医师规范化培训项目（Medical Residency Programs, MRP）开始探索基于胜任力的课程体系，以提升专科医师培训质量。
研究目的 开发内分泌与代谢病专科住院医师规范化培训项目（Medical Residency Programs in Endocrinology and Metabolism, MREM）的胜任力矩阵方案。
研究方法 本研究分为四个阶段。第一阶段开展文献调研并构建试点胜任力矩阵；第二阶段将试点矩阵应用于贝伦市的内分泌科医师，随后进行数据分析并构建结构化胜任力矩阵。第三阶段于2016年巴西内分泌与代谢病学术大会（Brazilian Congress of Endocrinology and Metabolism – CBEM 2016）上推行结构化矩阵，共回收有效问卷49份。基于德尔菲（Delphi）法，对两个矩阵共230项胜任力条目进行分析，编制了分歧率超过10%的胜任力条目问卷，并纳入专家提出的部分修改建议。第四阶段即最终阶段，同样采用德尔菲法，通过电子邮件发放问卷，开展数据分析并最终构建MREM方案。
研究结果 第二、第三、第四阶段的内分泌科医师应答率分别为73.3%、51%及76.4%，其中巴西东南部地区参与人数最多。试点矩阵共包含219项胜任力条目，结构化矩阵为230项，最终MREM方案则涵盖244项胜任力条目。糖尿病、肥胖症、代谢综合征及食欲改变相关的胜任力领域是修改建议与调整幅度最大的板块。全阶段研究中共仅剔除2项胜任力条目，第三阶段提出的修改建议均获一致通过。
研究结论 本研究最终完成的MREM方案共涵盖21个领域、244项胜任力条目，其中33项为先决条件胜任力，157项为核心胜任力，36项为期望胜任力，18项为高级胜任力。胜任力条目在MCPRMEM中的分布情况如下：“基础素养”模块共100项条目，包含15项先决条件、65项核心胜任力、14项期望胜任力及6项高级胜任力；“专业知识”模块共132项条目，包含18项先决条件、87项核心胜任力、19项期望胜任力及8项高级胜任力；“补充培训”模块共12项技能条目，无先决条件，包含5项核心技能、3项期望技能及4项高级技能。