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Planning for Change: Medical Education Program Design, Patient Care, and Measures of Effectiveness

  • Patricia J. Hicks
    Correspondence
    Address correspondence to Patricia J. Hicks, MD, UT Southwestern Medical Center, Division of General Pediatrics, Department of Pediatrics, Dallas, Texas.
    Affiliations
    University of Texas Southwestern Medical Center, Division of General Pediatrics, Department of Pediatrics, Dallas, Tex
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      Pediatric program directors are charged with organizing and directing the educational curriculum and instructional plans for programs educating future pediatricians. Program design is directly influenced by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Pediatrics (ABP), the public, and other influential factors present within the training environment (hospitals, institutional structure, and finances, to name a few). Many program requirements for general pediatrics and pediatric subspecialties call for the development of competence in areas where no peer-reviewed, published curriculum or instructional plans exist, much less measures of their effectiveness. Indeed, best evidence available for medical education may be quite limited for some very important areas of graduate medical education.
      • Harden R.M.
      • Grant J.
      • Buckley G.
      • Hart I.R.
      BEME guide no. 1: best evidence medical education.
      A described hierarchy of evaluation of effectiveness of education places performance in the patient care setting as the highest level—above learner participation, perception of learning, demonstration of knowledge, or understanding,
      • Kirkpatrick D.I.
      Evaluation of training.
      yet evidence of learner performance in the actual care of patients is often lacking.
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