医教协同背景下全科住院医师规范化培训带教师资对置信职业行为的需求调查

A survey on the demand for entrustable professional activities(EPAs)in the standardized training of general practitioners in the context of medical and educational collaboration

目的了解在当前全科住院医师(含全科专硕)规范化培训大背景下,带教师资对置信职业行为(entrustable professional activities,EPAs)的应用现状以及客观需求,探索建立全科住院医师EPAs评价考核体系的可行方案。方法采用问卷调查法,对158位临床带教师资进行调查,分析当前全科住院医师的规范化培训评价体系现状,以及他们对EPAs的了解程度和意见建议。结果在职业行为维度上,师资对医学知识和医学技能的考核效果认可度高;师资认为医德教育中的人文情怀考核不足;在实际需求上,带教师资对EPAs的重视顺序为:规范化(93.04%)、客观化(93.04%)、多维化(92.41%)、轻量化(90.51%)和多样化(86.04%)。结论应针对现行全科住院医师规范化培训体系中人文教育方面存在的短板,并基于中国全科住院医师培训的实际需求设计置信职业行为EPAs体系,在提高师资的教学胜任力的同时保障全科医学教育的产出成果。

Objective Under the background of standardized training for general practitioners(including professional master’s degree in general practice),this study aimed to explore a feasible scheme for establishing an evaluation and assessment system for entrustable professional activities(EPAs)for general residency training based on the current application status and objective demands of EPAs by clinical teaching physicians.Methods A questionnaire survey was conducted among 158 clinical teaching physicians to analyze the current evaluation system for standardized training of general practitioners,as well as their understanding and suggestions on EPAs.Results Compared with the emphasis on medical knowledge and skills,the humanistic care,represented by medical ethics education,was found to be insufficient in the standardized training of general practitioners.Regarding actual demands,the order of importance of EPAs by teaching physicians was as follows:standardization(93.04%),objectification(93.04%),multidimensionality(92.41%),lightness(90.51%),and diversity(86.04%).Conclusion An EPA system for professional confidence based on the actual demands of standardized training for general practitioners in China should be designed to address the shortcomings of humanistic education.This system will improve the teaching competence of faculty and guarantee the output of general medical education.