SMARTが常にベストでないとき:緊急医療の居住者目標設定の実践に関する調査
Alina Tsyrulnik1, Garrison Nord1, Linda Regan2
1Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USA.
AEM education and training
|February 13, 2026
まとめ
レジデントは,環境要因と関係性により,臨床環境では伝統的な目標設定が困難であると考えています. 効果的な医療教育のために,学習者中心の適応的戦略が推奨されています.
科学分野:
- 医療教育 医療教育について
- 質的研究とは,定性的な研究です.
- 自律学習による学習です.
背景:
- 目標設定は,自己規制学習と能力に基づく医療教育にとって極めて重要です.
- 学習者は,臨床環境で目標を設定する際に,しばしば困難や抵抗に直面します.
- この研究では,臨床目標設定に関する在住研修生の見解を調査しています.
研究 の 目的:
- 定住研修生の臨床目標設定に対する関係と認識を調査する.
- 緊急医療在職における効果的な目標設定のための障壁とファシリテーターを特定する.
- 医療訓練における目標設定の改善を図る.
主な方法:
- 緊急医療従事者との半構造面接を用いた誘導的定性研究.
- 意図的なサンプリングにより,訓練レベルや目標設定に関する意見の多様性が確保された.
- 分析は,コンストラクティビズムに基づく理論の枠組みの中で,恒常的な比較方法を使用した.
主要な成果:
- 住民は,高い認知負荷,予測不能なコンテンツ,および管理者の継続性の制限により,意味のある目標を運用するのに苦労しました.
- 効果的な目標設定は,監督者との真の双方向的な教育関係に依存していた.
- 厳格な目標構造 (例えば,SMART目標) は,しばしば臨床的現実と合致しなくなり,訓練生は柔軟で学習者中心の戦略を採用するようになった.
結論:
- 研修生は,学習環境の"邪悪さ"または"優しさ"の影響を受け,臨床教育に伝統的な目標設定を適用する課題に直面します.
- 関係によって支えられ,臨床的文脈に合わせた,適応的な目標設定の実践が推奨されます.
- 将来の介入は,柔軟で縦断的な,学習者中心の目標戦略に焦点を当てなければならない.
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