基于置信职业行为的八年制临床医学专业学生临床实习阶段胜任力评价的探索

doi:10.3760/cma.j.cn115259-20220209-00142

中华医学教育杂志 ›› 2022, Vol. 42 ›› Issue (8): 757-760.DOI: 10.3760/cma.j.cn115259-20220209-00142

基于置信职业行为的八年制临床医学专业学生临床实习阶段胜任力评价的探索

王玮¹, 吴浩¹, 齐心², 李珊³, 刘兆平⁴, 王颖¹, 李海潮⁵

¹北京大学第一医院教育处,北京 100034;
²北京大学第一医院整形烧伤科,北京 100034;
³北京大学第一医院儿科,北京 100034;
⁴北京大学第一医院心血管内科,北京100034;
⁵北京大学第一医院,北京 100034

收稿日期:2022-02-09 发布日期:2022-08-01
通讯作者: 齐心, Email: randyq@126.com
基金资助:
北京大学教育研究中心2021年度“北大研究”课题(2021ZZ04)

Exploration of evaluation based on entrustable professional activities during internship for eight-year program undergraduates of clinical medicine

Wang Wei¹, Wu Hao¹, Qi Xin², Li Shan³, Liu Zhaoping⁴, Wang Ying¹, Li Haichao⁵

¹Department of Education;
²Department of Plastic Surgery & Burns;
³Department of Pediatrics;
⁴Department of Cardiology, First Hospital, Peking University, Beijing 100034, China;
⁵ First Hospital, Peking University, Beijing 100034, China

Received:2022-02-09 Published:2022-08-01
Contact: Qi Xin, Email: randyq@126.com
Supported by:
Peking University Research Project in 2021, The Center for Institutional Research, PKU (2021ZZ04)

摘要/Abstract

摘要： 目的对八年制临床医学专业学生临床实习阶段进行基于置信职业行为(entrustable professional activities,EPAs)的评价,以发现临床实习教学中的不足。方法采用问卷调查方法。选取在北京大学第一医院进行临床实习的2017级八年制临床医学专业50名学生进行EPAs的自我评价(自评)和带教教师评价(他评),采用Wilcoxon符号秩检验对自评和他评的结果进行比较,并将每个指标评价为3级及以上的比例和无法评价的比例进行统计。结果大多数指标的自评和他评结果一致,如EPA1(接诊患者)、EPA5(医疗文书书写)、EPA6(病例汇报)的自评和他评结果均为3(3,4);少数指标存在差异,如EPA10(知情同意)的自评和他评结果分别为3(3,4)和3(2,3),其差异具有统计学意义(P＜0.05)。部分指标自评和他评为3级及以上的比例均较高,如EPA1(接诊患者)、EPA5(医疗文书书写)、EPA6(病例汇报)的比例分别为100.0%和88.2%、94.0%和91.8%、90.0%和91.8%。部分指标自评和他评为3级及以上的比例较低,如EPA8(危急重症识别与处理)、EPA9(患者转运与交接)的比例分别为30.0%和43.6%、50.0%和51.8%。结论八年制临床医学专业学生EPAs自评和他评结果基本一致,基本达到临床实习教学要求,部分EPAs指标评价结果与住院医师入职基本要求相比仍有不足,建议进一步完善临床实习教学,以促进与毕业后教育的平稳过渡。

关键词: 医学生, 置信职业行为, 八年制临床医学专业, 实习, 评价

Abstract: Objective Evaluation based on entrustable professional activities(EPAs)was implemented for eight-year program undergraduates of clinical medicine during the period of internship in order to find the deficiencies in clinical training. Methods Fifty students of grade 2017 who were trained as internship in Peking University First Hospital were enrolled in the research. A questionnaire survey was carried out for self-assessment and trainer's EPAs-based evaluation. Wilcoxon test was applied for comparing the self-assessment and trainer's evaluation.The proportion of each EPAs item reached level 3 or above and the proportion that could not be evaluated were calculated. Results Results of most items of self-assessment were consistent with trainer's evaluation, such as EPA1 (gathering history and performing physical examination during patient encounter), EPA5 (prepare and complete medical documents), and EPA6 (provide oral presentation of a case or a clinical encounter), which were all 3(3,4). Significant difference was found between self-assessment and trainer's evaluation in several items such as EPA10 (obtaining informed consent for clinical tests and/or procedures) which was 3 (3,4) and 3 (2,3) respectively (P < 0.05),. The proportion of items such as EPA1、EPA5、EPA6 which were clearly required by clinical practice training rated as level 3 or above was high in both self-assessment and trainer's evaluation, which were 100.0% and 88.2%, 94.0% and 91.8%, 90.0% and 91.8% respectively. The proportion of items such as EPA8 ( identification of clinical emergency and critical illness and providing initial management)、EPA9 ( transit and hand over the patient) rated as level 3 or above was low in both self-assessment and trainer's evaluation which were 30.0% and 43.6%, 50.0% and 51.8% respectively. Conclusions The eight-year program students of clinical medicine basically meet the requirements of clinical practice training, and evaluation results of EPAs items showed the distance to the entrance standards of residents' training. It is suggested to improve clinical practice training to support the promote the transition from school education to post-graduate medical education.

Key words: Students,Medical, Entrustable professional activities, Eight-year program, Internship, Evaluation

中图分类号:

R-05

王玮, 吴浩, 齐心, 李珊, 刘兆平, 王颖, 李海潮. 基于置信职业行为的八年制临床医学专业学生临床实习阶段胜任力评价的探索[J]. 中华医学教育杂志, 2022, 42(8): 757-760.

Wang Wei, Wu Hao, Qi Xin, Li Shan, Liu Zhaoping, Wang Ying, Li Haichao. Exploration of evaluation based on entrustable professional activities during internship for eight-year program undergraduates of clinical medicine[J]. Chinese Journal of Medical Education, 2022, 42(8): 757-760.

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基于置信职业行为的八年制临床医学专业学生临床实习阶段胜任力评价的探索

Exploration of evaluation based on entrustable professional activities during internship for eight-year program undergraduates of clinical medicine

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