妇产科专科医师置信职业行为核心指标的构建研究

Construction of core indicators for entrustable professional activities in specialists in obstetrics and gynecology

目的构建妇产科专科医师置信职业行为核心指标。方法由妇产科专家、医学教育专家组成研究小组, 通过文献研究法, 结合临床实践, 设计妇产科专科医师置信职业行为核心指标;然后使用德尔菲法, 于2021 年3月至2023年1月展开两轮专家函询, 进行筛选优化, 进一步确定核心指标。结果两轮咨询专家积极系数均为100%, 权威系数达到0.82;肯德尔和谐系数分别为0.221和0.213(均P<0.01)。构建了10项妇产科专科医师置信职业行为核心指标及其内容说明, 专家对所列出的10项置信职业行为的重要性认可程度均超过80%, 变异系数都小于0.25。确定了各项指标在专科医师结业时的预期置信级别, 位于3~5级之间;其中门诊病人诊治评级最高, 达到4.48, 介于精通与专家之间;腹腔镜子宫切除评级最低, 为3.52, 介于胜任与精通之间。结论本研究初步构建了妇产科专科医师置信职业行为核心指标, 为专科医师规范化培训提供新探索。

Objective To construct the core indicators for entrustable professional activities in specialists in obstetrics and gynecology.Methods A study group was formed by the specialists in obstetrics and gynecology and the experts in medical education.The core indicators for entrustable professional activities were constructed for the specialists in obstetrics and gynecology based on literature review and clinical practice,and then the Delphi method was used to conduct two rounds of expert letter consultation for screening and optimization from March 2021 to January 2023 to further identify the core indications.Results The expert positive coefficient was 100%for the two rounds of consultation,with an expert authority coefficient of 0.82,and the Kendall's coefficient of concordance was 0.221 and 0.213,respectively(both P<0.01).Ten core indicators and their content descriptions were constructed for entrustable professional activities in obstetrics and gynecology specialists,and the experts had a degree of recognition of more than 80%for the importance of these ten entrustable professional activities,with a coefficient of variation of<0.25.This study determined the expected entrustable level of each indicator for specialists at the completion of the course,which ranged from grade 3 to 5;the highest level of 4.48 was observed for the diagnosis and treatment of outpatients,which was between the levels of mastery and expert;the lowest level of 3.52 was observed for laparoscopic hysterectomy,which was between the levels of competency and mastery.Conclusion This study preliminarily constructs the core indicators for entrustable professional activities in specialists in obstetrics and gynecology,which provides a new exploration for the standardized training of specialists.