Exploration of the evaluation with the entrustable professional activities scale in standardized residency training

doi:10.3760/cma.j.cn115259-20220826-01082

Chinese Journal of Medical Education ›› 2023, Vol. 43 ›› Issue (2): 156-160.DOI: 10.3760/cma.j.cn115259-20220826-01082

Exploration of the evaluation with the entrustable professional activities scale in standardized residency training

Liu Zhe¹, Liu Lin², Zhou Wenjing³, Jiang Zhehan⁴, Qi Jianguang⁵, Yan Hui⁵, Li Haichao⁶, Qi Xin⁷

¹Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China;
²Department of Endocrinology, Peking University First Hospital, Beijing 100034, China;
³Department of Health Policy and Management,School of Public Health, Peking University, Beijing 100191, China;
⁴Institute of Medical Education & National Center for Health Professions Education Development, Peking University, Beijing 100191, China;
⁵Department of Pediatrics, Peking University First Hospital, Beijing 100034, China;
⁶Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China;
⁷Department of Plastic Surgery & Burns, First Hospital Peking University, Beijing 100034, China

Received:2022-08-26 Online:2023-02-01 Published:2023-01-31
Contact: Qi Xin, Email: randyq@126.com
Supported by:
2021 Resident Doctor Standardized Training Quality Improvement Project (2021034);2021 ″Peking University Research″ Project(2021ZZ04)

Abstract

Abstract: Objective To explore the application of the entrustable professional activities scale in standardized residency training. Methods In January 2022, 230 residents who received standardized training in the Department of Internal Medicine, Surgery, Obstetrics & Gynecology and Pediatrics of Peking University First Hospital from December 2021 to January 2022 and 71 clinical instructors were selected as the research participants by purposive sampling. Clinical instructors were instructed to assess trainees using the entrustable professional activities scale for 15 entrustable professional activities. The Kruskal-Wallis H test was used to compare the differences in entrustable levels among residents of different disciplines and grades to determine whether the educational principle of hierarchical progression could be achieved, and the generalization coefficient was used to test the evaluation confidence of the entrustable professional activities scale. Results The generalizability coefficient of the entrustable professional activities scale was 0.980. Entrustable levels from internal medicine, obstetrics & gynecology and pediatrics second-year residents by clinical instructors were higher than those of the first-year residents[for example, in history-taking and physical examination during patient encounter by obstetrics & gynecology residents: 4.0 (0.6) vs. 3.0 (0), all adjust P<0.001], and the third-year residents' entrustable levels were higher than the second-year residents' [for example, in history-taking and physical examination during patient encounter by obstetrics & gynecology residents: 4.5 (0.8) vs. 4.0 (0.6), all adjust P<0.001]. Levels of entrustability by clinical instructors from surgical residents were no significant differences between the first-year residents and the second-year residents either [for example, in indentify and manage the general clinical conditions: 4.0 (0.3) vs. 4.0 (0.5), adjust P=0.591], and there were no significant differences between the second-year residents and the third-year residents [for example, in indentify and manage the general clinical conditions: 4.0(0.5)vs.4.0(0.5), adjust P=0.047]. Conclusions The entrustable professional activities scale is reliable and stable, and can effectively reflect the effect of standardized training of residents. Among them, the standardized training of obstetrics & gynecology residents conforms to the principle of hierarchical and progressive training, and it is necessary to re-plan the annual training programme for internal medicine, surgery, and pediatrics.

Key words: Standardized residency training, Entrustable professional activities, Competency-based medical education

CLC Number:

Liu Zhe, Liu Lin, Zhou Wenjing, Jiang Zhehan, Qi Jianguang, Yan Hui, Li Haichao, Qi Xin. Exploration of the evaluation with the entrustable professional activities scale in standardized residency training[J]. Chinese Journal of Medical Education, 2023, 43(2): 156-160.

References

[1] 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.
[2] 陈心航,吴红斌,江哲涵,等. 国际置信职业行为研究在医学教育中的发展与启示[J]. 中华医学教育杂志,2020,40(12):945-950. DOI:10.3760/cma.j.cn115259-20201012-01447.
[3] Crossley J, Johnson G, Booth J, et al. Good questions, good answers: construct alignment improves the performance of workplace-based assessment scales[J]. Med Educ, 2011,45(6):560-569. DOI:10.1111/j.1365-2923.2010.03913.x.
[4] 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.
[5] 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.
[6] 曾庆奇,刘婧,陈声宇,等. 规范化培训对住院医师胜任力影响的研究[J]. 中华医学教育杂志, 2022,42(5):468-472. DOI:10.3760/cma.j.cn115259-20210915-01163.
[7] Noreen MW,Richard JS,Edward HH. Reliability coefficients and generalizability theory[J] . Handbook of Statistics, 2006(26):81-124. DOI:10.1016/S0169-7161(06)26004-8.
[8] Jafari M, Ansari-Pour N. Why, When and how to adjust your P values? [J]. Cell, 2019,20(4):604-607. DOI:10.22074/cellj.2019.5992.
[9] Edgar L, Roberts S, Yaghmour NA, et al. Competency crosswalk: a multispecialty review of the Accreditation Council for Graduate Medical Education milestones across four competency domains[J]. Acad Med,2018,93(7):1035-1041. DOI:10.1097/ACM.000000000
0002059.
[10] Edgar L, Roberts S, Holmboe E. Milestones 2.0: a step forward[J]. J Grad Med Educ,2018,10(3):367-369. DOI:10.4300/JGME-D-18-00372.1.
[11] Lindeman B, Brasel K, Minter R M, et al. A phased approach: the general surgery experience adopting entrustable professional activities in the United States[J]. Acad Med, 2021,96(7S):S9-S13. DOI:10.1097/ACM.0000000000004107.
[12] Torre DM, Schuwirth L, Van der Vleuten C. Theoretical considerations on programmatic assessment[J]. Med Teach, 2020,42(2):213-220. DOI:10.1080/0142159X.2019.1672863.
[13] Watling CJ, Ginsburg S. Assessment, feedback and the alchemy of learning[J]. Med Educ, 2019,53(1):76-85. DOI:10.1111/medu.13645.
[14] Tsuei SH, Lee D, Ho C, et al. Exploring the construct of psychological safety in medical education[J]. Acad Med,2019,94(11S):S28-S35. DOI:10.1097/ACM.0000000000002897.

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Exploration of the evaluation with the entrustable professional activities scale in standardized residency training

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