当 SMART 不总是最好的时候:对紧急医疗住院目标设定实践的调查
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
概括
由于环境因素和关系,居民在临床环境中发现传统的目标设定具有挑战性. 适应性,以学习者为中心的策略是有效的医疗教育的建议.
科学领域:
- 医疗教育 医学教育
- 定性研究是指质量研究.
- 自主调节的学习学习
背景情况:
- 目标设定对于自我调节的学习和基于能力的医学教育至关重要.
- 在临床环境中,学习者经常在设定目标方面遇到困难或阻力.
- 这项研究调查了居民实习生对临床目标设置的观点.
研究的目的:
- 探索居民实习生与临床目标设定之间的关系和对临床目标设定的看法.
- 识别障碍物和促进者,以有效的目标设定在紧急医疗住院.
- 在医疗培训中为目标设定实践的改进提供信息.
主要方法:
- 诱导性定性研究,采用半结构化采访,对紧急医疗的住院医生进行调查.
- 有目的的抽样确保了培训水平的多样性和对目标设定的意见的多样性.
- 分析采用了在构造主义基础理论框架内的恒定比较方法.
主要成果:
- 由于高认知负载,不可预测的内容和有限的监督连续性,居民们努力实现有意义的目标.
- 有效的目标设定取决于与监督人员建立真正的双向教育关系.
- 严格的目标结构 (例如,SMART目标) 往往与临床现实不一致,导致学员采用灵活,以学习者为中心的策略.
结论:
- 实习生面临的挑战是将传统的目标设定应用于临床教育,受学习环境的"邪恶"或"善良"的影响.
- 建议采用适应性目标设定实践,以关系为基础,并根据临床背景量身定制.
- 未来的干预措施应侧重于灵活,纵向和以学习者为中心的目标策略.
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