加拿大家庭医学强化技能培训从急诊医学延伸到多个领域,以满足社区服务和家庭医生职业发展的需求。本文介绍了加拿大家庭医学强化技能培训的情况,包括强化技能培训的领域、8个附加能力证书项目的重点培训内容和培训效果。经过强化技能培训家庭医生的工作模式与社区需求相契合时,对于提供综合性医疗照护具有正面影响。学习和借鉴加拿大的经验,有益于我国探索建立适合国情的全科医学专科医师培训体系。
To meet the community needs as well as the personal professional development of family physicians, enhanced skills (ES) programs have extended from emergency medicine to multiple areas in Canada. This article introduced Canadian family medicine ES including the academic areas, priority topics of 8 certificates for added competence (CACs) and the impact. Enhancing skill family physicians have a positive impact on the delivery of comprehensive care when they work with the collaborative models that align with the needs of communities. It is useful to learn from Canadian experiences for the development of general practitioner training system in China.
[1] Yellamaty V, Ball L, Crossland L, et al. General practitioners with special interests: an integrative review of their role, impact and potential for the future[J]. Aust J Gen Pract, 2019,48(9):639-643. DOI: 10.31128/AJGP-02-19-4849.
[2] Lemire F. Enhanced skills in family medicine: update[J]. Can Fam Physician, 2018,64(2):160.
[3] The College of Family Physicians of Canada. Residency program accreditation[EB/OL]. [2020-08-14].https://www.cfpc.ca/en/education-professional-development/residency-program-accreditation.
[4] Dhillon P. Shifting into third gear: current options and controversies in third-year postgraduate family medicine programs in Canada[J]. Can Fam Physician, 2013,59(9):e406-e412.
[5] The College of Family Physicians of Canada. Understanding the impact of the CFPC certificates of added competence[EB/OL]. [2020-08-14]. https://www.cfpc.ca/CFPC/media/PDF/2020-04-CAC-Impact-Study-Report.pdf.
[6] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in care of the elderly[EB/OL]. [2020-08-14]. https://portal.cfpc.ca/resourcesdocs/uploadedFiles/Education/COE_KF_Final_ENG.pdf.
[7] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in family practice anesthesia[EB/OL]. [2020-08-14]. https://portal.cfpc.ca/resourcesdocs/uploadedFiles/Education/FPA_KF_Final_ENG.pdf.
[8] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in palliative care[EB/OL]. [2020-08-14]. https://portal.cfpc.ca/resourcesdocs/uploadedFiles/Education/PC_KF_Final_ENG.pdf.
[9] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in sport and exercise medicine[EB/OL]. [2020-08-14]. https://portal.cfpc.ca/resourcesdocs/uploadedFiles/Education/SEM_KF_Final_ENG.pdf.
[10] The College of Family Physicians of Canada. Emergency medicine key features of the priority topics for the assessment of competence in family medicine at the enhanced skills level[EB/OL]. [2020-08-14]. https://www.cfpc.ca/CFPC/media/Images/PDF/EM_KF-2017_Final_ENG.pdf#page=2.
[11] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in addiction medicine[EB/OL]. [2020-08-14]. https://portal.cfpc.ca/ResourcesDocs/uploadedFiles/Education/Website-Addiction-Medicine-PT-KF-2018.pdf.
[12] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in enhanced surgical skills[EB/OL]. [2020-08-14]. https://portal.cfpc.ca/ResourcesDocs/uploadedFiles/Education/ESS-Priority-Topics-Key-Features-EN-20190917.pdf.
[13] The College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in obstetrical surgical skills[EB/OL]. [2020-08-14].https://portal.cfpc.ca/ResourcesDocs/uploadedFiles/Education/OSS-Priority-Topics-Key-Features-EN-20190918.pdf.
[14] The College of Family Physicians of Canada. CanMEDS-Family Medicine 2017: a competency framework for family physicians across the continuum[EB/OL]. [2020-08-14].https://www.cfpc.ca/CFPC/media/Resources/Medical-Education/CanMEDS-Family-Medicine-2017-ENG.pdf.
[15] Slade S, Ross S, Lawrence K, et al. Extended family medicine training: measuring training flows at a time of substantial pedagogic change[J]. Can Fam Physician, 2016,62(12):e749-e757.
[16] Biringer A, Abells D, Boro J, et al. Enhanced skills training in family medicine maternity care: cross-sectional study of graduates' experiences[J]. Can Fam Physician, 2019,65(12):e531-e537.
[17] Caron N, Iglesias S, Friesen R, et al. A proposal for the curriculum and evaluation for training rural family physicians in enhanced surgical skills[J]. Can J Surg, 2015,58(6):419-422. DOI: 10.1503/cjs.002215.
[18] Vogel L. Are enhanced skills programs undermining family medicine?[J]. CMAJ, 2019,191(2):E57-E58. DOI: 10.1503/cmaj.109-5697.
