置信职业行为的演进、内涵与实践

The evolution,connotation,and practice of entrustable professional activities

胜任力导向的医学教育是“以终为始”、结果导向的教育模式。随着医学教育改革的深入,从能力和行为角度分别发展出不同的胜任力模型。其中,置信职业行为逐渐成为国内外医学教育研究和实践的热点和难点。本文以北美地区医学教育发展情况为例,探讨胜任力概念中行为与能力的关系,以及里程碑体系的发展历程。结合临床教学实践,梳理了置信职业行为的内涵与实践要点,比较国内外不同阶段置信职业行为的异同,助推置信职业行为的构建与应用。

Competency-based medical education is a outcome-oriented education mode that"begins with the end in mind".With the deepening of medical education reform,different competency models have been developed from the perspectives of competence and activities.Among them,Entrustable Professional Activities(EPAs)have gradually become a hot and difficult topic in medical education research and practice both in China and globally.This article explores the relationship between activities and competence in the concept of competency,as well as the development process of milestone systems,taking the development of medical education in North America as an example.Based on clinical teaching practice,this paper summarizes the connotation and practice of EPAs and compares the similarities and differences of EPAs at different stages in China and globally.The aim is to promote the construction and application of EPAs.