Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_112_библиотеки_им_акад_М_И_Перельмана
.pdf
https://t.me/med1917
Practical Guide to the Assessment
of Clinical Competence
THIRD EDITION
EDITED BY
Eric S. Holmboe, MD
Professor Adjunct, Medicine
Yale University
New Haven, Connecticut;
Adjunct Professor of Medicine
Feinberg School of Medicine, Northwestern University
Chicago, Illinois
United States
Steven J. Durning, MD, PhD
Professor and Vice Chair, Department of Medicine
Director, Center for Health Professions Education (CHPE)
Uniformed Services University
Bethesda, Maryland
https://t.me/med1917
United States
https://t.me/med1917
Copyright
Elsevier
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
PRACTICAL GUIDE TO THE ASSESSMENT OF CLINICAL
COMPETENCE, ISBN: 978-0-443-11226-3 THIRD EDITION
Copyright © 2025 Eric Holmboe, Richard Hawkins and
Steven Durning, Published by Elsevier Inc. All rights are
reserved, including those for text and data mining, AI
training, and similar technologies.
For chapter 2: Copyright © NBME. Published by Elsevier
Inc. All Rights are reserved, including those for text and
data mining, AI training, and similar technologies.
No part of this publication may be reproduced or
transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any
information storage and retrieval system, without
permission in writing from the publisher. Details on how to
https://t.me/med1917
seek permission, further information about the Publisher’s
permissions policies and our arrangements with
organizations such as the Copyright Clearance Center and
the Copyright Licensing Agency, can be found at our
website: www.elsevier.com/permissions.
This book and the individual contributions contained in it
are protected under copyright by the Publisher (other than as
may be noted herein).
Notice
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any
information, methods, compounds or experiments described
herein. Because of rapid advances in the medical sciences, in
particular, independent verification of diagnoses and drug
dosages should be made. To the fullest extent of the law, no
responsibility is assumed by Elsevier, authors, editors or
contributors for any injury and/or damage to persons or
property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material
herein.
Previous editions copyrighted 2018 and 2008
Publisher: Elyse W. O’Grady
Senior Content Development Specialist: Vaishali Singh
https://t.me/med1917
Publishing Services Manager: Shereen Jameel
Project Manager: Gayathri S
Design Direction: Patrick C. Ferguson
Printed in India
Last digit is the print number:987654321
https://t.me/med1917
Preface
Assessment of health professionals across the continuum of medical
education and practice is essential for advancing high-quality and
safe healthcare and improving health for patients and the public.
Assessment of clinical competence is a core element of educational
professionalism and underlies effective professional self-regulation; it
is essential for fulfilling our professional obligation as educators to
assure the public that the graduates of health professions education
training programs are truly prepared to enter the next stage of
education and/or practice. Despite substantial attention to the quality
and safety of healthcare over the past 25 years, major deficiencies and
concerns persist in healthcare fields. The transformation of medical
education, and the education of all healthcare professionals, is
appropriately seen as part of the solution. Effective assessment is a
vital component of this difficult transformation that is only further
challenged by a once-in-a-century pandemic.
First and foremost, medicine is a service profession. As medical
educators, it is vital that we develop and use high-quality assessment
methods embedded within effective assessment systems to meet our
primary obligation to the public and patients we serve. Furthermore,
effective assessment provides the necessary data for robust feedback,
coaching, and guidance to support professional growth and
development. Learners are entitled to no less; without assessment,
feedback, and coaching, the attainment of mastery, the ultimate goal
of outcomes-based education, is nearly impossible.
https://t.me/med1917
It has been more than 5 years since the second edition of this book,
and much has changed during this relatively brief period. We have
seen an encouraging acceleration of the development of assessment
tools, methods, and research despite the COVID-19 pandemic.
Competency-based medical educational (CBME) models are being
implemented more widely but variability in the uptake of CBME
continues across the globe. However, most health professions
educational systems have recognized the value of an outcomes-based
approach using CBME models. The philosophical underpinnings of
CBME continue to inform curricular and programmatic assessment
changes, accreditation and certification approaches, and the
credentialing of healthcare professionals. CBME has highlighted the
importance of rebalancing more traditional methods of assessment
with other methods of assessment, especially in the workplace. Fully
implemented, CBME frameworks embrace holistic and constructivist
approaches to assessment; successful assessment programs will need
to incorporate a diverse range of educational and assessment theories
and methods.
We are pleased to be able to share changes and advances in
assessment that have occurred since 2018. Many readers let us know
that one of the main benefits of both editions of this book was the
practical suggestions in each chapter that could be implemented in
training programs. We have attempted to stay true to that philosophy
by adding new chapters and more supplemental material. All other
chapters have undergone extensive revision to be up to date and
practical.
Both of us have spent much of our professional lives thinking,
learning, and teaching about assessment. Like many of you, much of
our initial learning was through trial and error, occurring as a result
of being assigned positions of responsibility in determining the
competence of students and residents in internal medicine. We have
also had the privilege to work within national organizations involved
https://t.me/med1917
in the assessment of physicians across the continuum. Assessment is
not routinely seen by physicians and other health professionals as a
welcome activity, especially when it comes from an external entity.
Yet without assessment, feedback and coaching are almost impossible
and continuous professional growth is difficult. We hope that by
sharing part of our own journey and the journey of our colleagues
who contributed chapters and their expertise, we can help the reader
address important assessment challenges they are facing in their own
context and also contribute to larger conversations around assessment
as a mechanism to improve healthcare and health for all.
The primary purpose of this book is to provide a practical guide to
developing assessment programs using a systems lens. No single
assessment method is sufficient to determine something as complex
as clinical competence. Educators will need to develop programs of
assessment (i.e., programmatic assessment) by choosing the optimal
combination of methods, based on the best evidence available, for
their local context. This book has been organized around the various
assessment methods and instruments and how individuals with
responsibilities for assessment can apply these methods and
instruments in their own setting. We have provided an overview of
key educational theories applicable to help the reader understand
how best to use the assessment method and its purpose. Each chapter
provides information on the strengths and weaknesses of the
assessment method, along with information about specific tools.
Many chapters provide examples of assessment instruments along
with suggestions on faculty development and effective
implementation of the assessment method. Each chapter also contains
an annotated bibliography of helpful articles for additional reading.
Chapter 1 provides an overview of basic assessment principles with
a focus on the rise and impact of competency-based education and
the core components of CBME to achieve desired educational and
clinical care outcomes. Chapter 2 provides a useful primer on key
https://t.me/med1917
theories and aspects of psychometrics, a discipline that remains
essential to effective assessment. Chapter 3 is a new chapter on
programs of assessment, or programmatic assessment, using a
systems approach. Chapter 4 explores the evolving approaches to the
use of rating scales, especially developmental and entrustment scales,
a common component of assessment forms and surveys, highlighting
the importance of appropriate frameworks and anchors. Direct
observation in the workplace, especially of clinical skills, is the focus
of Chapter 5 with multiple practical suggestions on how to better
prepare faculty in this essential assessment skill, and this chapter also
provides access to multiple videos that can be used for practice and
faculty development. Chapter 6 explores the assessment of clinical
skills with standardized patients, another form of direct observation
in controlled settings.
Chapter 7 provides an extensive overview on the effective use of the
traditional written, standardized tests of medical knowledge and
clinical reasoning, still an essential part of an assessment program.
However, the need for high-quality assessment of clinical reasoning
in the workplace has grown in importance with the recognition of the
persistent and pernicious problem of diagnostic and management
errors in clinical practice. This is the focus of Chapter 8. Chapter 9
covers the assessment of procedural competence in the workplace,
another area experiencing new approaches and of major interest for
medical educators in an era of concerns about appropriate
supervision and patient safety.
Chapter 10 addresses the importance of assessing evidence-based
practice, an essential competency in a time of rapidly expanding
medical knowledge and growing use of clinical decision support at
the point of care, an area that is also being buffeted by advances in
clinical support tools and augmented intelligence. Chapter 11 focuses
on the multiple ways to assess performance in clinical practice using
different types of quality and safety measures. The growing use of
https://t.me/med1917
Соседние файлы в папке Библиотека им академика М.И. Перельмана