目的 构建口腔内科住院医师规范化培训中牙体牙髓专业置信职业行为指标。方法 通过文献研究,编制口腔内科住院医师规范化培训中牙体牙髓专业置信职业行为指标专家函询表,采用德尔菲法于2024年4至6月对22位专家进行2轮咨询,筛选、优化置信职业行为指标,采用均数、变异系数描述指标评分情况,以专家权威程度和肯德尔协调系数判断结果的可靠性。结果 2轮函询的有效问卷回收率分别为95.4%和100.0%,置信职业行为指标评分均大于3.5分、变异系数均小于0.25,专家权威程度分别为0.90和0.91,肯德尔协调系数分别为0.677和0.532(均P<0.001),最终纳入13个口腔内科住院医师规范化培训中牙体牙髓专业置信职业行为指标,确定了各项指标在住院医师不同培训阶段的预期置信级别。结论 口腔内科住院医师规范化培训中牙体牙髓专业置信职业行为指标具有科学性和可靠性,可以为胜任力导向的口腔内科住院医师牙体牙髓专业的规范化培训和客观化评价提供参考。
Objective To establish the entrustable professional activities (EPAs) for operative dentistry and endodontics in oral medicine residency training. Methods Based on literature research, an expert consultation questionnaire on EPAs for the operative dentistry and endodontics in standardized residency training of oral medicine was developed. From April to June 2024, the Delphi method was used to conduct two rounds of expert letter consultation with 22 experts for screening and optimization the indicators for EPAs. The scores of indicators were evaluated using means and coefficient of variation, and the degree of expert authority and Kendall's W coefficient were used to test the reliability of results. Results The response rates for the two rounds of questionnaires were 95.4% and 100.0%, respectively. The mean scores for all indicators exceeded 3.5, and the coefficients of variation were all below 0.25. The authority coefficients were 0.90 and 0.91 for the two rounds, respectively, and the Kendall's coefficients of concordance were 0.677 and 0.532 for the two rounds (all P<0.001). A total of 13 indicators for EPAs were established, which defined the entrustable level of each EPA that residents should reach at different stages. Conclusions The EPAs for operative dentistry and endodontics in oral medicine residency training have been preliminarily established, which is scientific and reliable,and can provide reference for competency-oriented standardized training and Objective assessment.
[1] 中国医师协会.住院医师规范化培训内容与标准[EB/OL]. (2022-12-01) [2024-08-01]. https://www.ccgmecmda.cn/news/15117/1/article
[2] ten Cate O. Entrustability of professional activities and competency-based training[J]. Med Educ, 2005,39(12):1176-1177. DOI: 10.1111/j.1365-2929.2005.02341.x.
[3] 李珊,周文静,齐心,等.置信职业行为在儿科住院医师培训中的实践研究[J].中华医学教育杂志,2022, 42(3): 263-267.DOI:10.3760/cma.j.cn115259-20210704-00839.
[4] 安方,窦莎,祝洪澜,等.妇产科专科医师置信职业行为核心指标的构建研究[J].中华医学教育探索杂志,2023, 22(10): 1441-1445.DOI:10.3760/cma.j.cn116021-20230311-01437.
[5] 冯莉莉,龚晓杰,宋琳琳,等.基于置信职业行为构建胜任力导向的急诊住院医师规范化培训课程[J].中华医学教育杂志,2021, 41(4): 347-350.DOI:10.3760/cma.j.cn115259-20200612-00910.
[6] 周娜,张静,路潜,等.口腔护理硕士专业学位研究生置信职业行为指标的构建研究[J].中华医学教育杂志,2023,43(8): 633-637.DOI:10.3760/cma.j.cn115259-20221031-01373.
[7] 曹钰彬,姜志深,潘剑.置信职业行为评估促进口腔医学专业实践教育改革发展的分析与展望[J].中国实用口腔科杂志,2024,17(3):336-341.DOI:10.19538/j.kq.2024.03.013.
[8] 孙健,李琳娜,田雪,等.基于置信职业行为的皮肤科住院医师规范化培训课程建设研究与实践[J]. 中华医学教育杂志,2024, 44(2): 141-146.DOI:10.3760/cma.j.cn115259-20230204-00094.
[9] 李海潮. 我国医师胜任力模型的形成性评价:设计,实施与思考[J]. 中华医学教育探索杂志, 2024, 23(1): 7-11.DOI:10.3760/cma.j.cn116021-20231215-01607.
[10] Ramaswamy V, Fitzgerald M, Danciu T, et al. Entrustable professional activities framework for assessment in predoctoral dental education, developed using a modified Delphi process [J]. J Dent Educ, 2021, 85(8): 1349-1361.DOI:10.1002/jdd.12620.
[11] Ramaswamy V, Munz SM, Nalliah R, et al. Entrustable professional activities framework for assessment of patient handoffs in dentistry [J]. J Dent Educ, 2022, 86(1): 88-97.DOI:10.1002/jdd.12787.
[12] Tonni I, Gadbury-Amyot CC, Govaerts M, et al. ADEA-ADEE shaping the future of dental education III: assessment in competency-based dental education: ways forward [J]. J Dent Educ, 2020, 84(1): 97-104.DOI:10.1002/jdd.12024.
[13] Ehlinger C, Fernandez N, Strub M. Entrustable professional activities in dental education: a scoping review [J]. Br Dent J, 2023, 234(3): 171-176.DOI:10.1038/s41415-023-5503-8.
[14] Hissink E, Fokkinga WA, Leunissen RRM, et al. An innovative interprofessional dental clinical learning environment using entrustable professional activities [J]. Eur J Dent Educ, 2022, 26(1): 45-54.DOI:10.1111/eje.12671.
[15] Arunachalam S, Pau A, Nadarajah VD, et al. Entrustable professional activities in undergraduate dental education: a practical model for development and validation [J]. Eur J Dent Educ, 2023, 27(2): 332-342.DOI:10.1111/eje.12809.
[16] Ramaswamy V, Danciu T, Kennedy EN, et al. American dental education association compendium entrustable professional qctivities workgroup report [J]. J Dent Educ, 2024, 88(5): 639-653.DOI:10.1002/jdd.13542.
[17] 李韶容,张琛. “推理解密式”训练法在牙体牙髓病教学中的初步探索[J]. 牙体牙髓牙周病学杂志, 2024, 29(8): 490-496.DOI:10.15956/j.cnki.chin.j.conserv.dent.2024.08.11.
[18] Ten Cate O, Chen HC, Hoff RG, et al. Curriculum development for the workplace using entrustable professional activities (EPAs): AMEE Guide No. 99 [J]. Med Teach, 2015, 37(11): 983-1002.DOI:10.3109/0142159X.2015.1060308.
[19] 齐心,金哲,韩晓宁,等.住院医师置信职业行为指标的构建研究[J].中华医学教育杂志,2021, 41(2): 104-108.DOI:10.3760/cma.j.cn115259-20201117-01599.
[20] 屈京楼,朱亚鑫,曲波. 德尔菲法在医学教育研究中的应用[J].中华医学教育杂志, 2019, 39(3): 227-230.DOI:10.3760/cma.j.issn.1673-677X.2019.03.017.
