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Exploration of the evaluation with the entrustable professional activities scale in standardized residency training
Liu Zhe, Liu Lin, Zhou Wenjing, Jiang Zhehan, Qi Jianguang, Yan Hui, Li Haichao, Qi Xin
2023, 43 (2):
156-160.
DOI: 10.3760/cma.j.cn115259-20220826-01082
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.
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