1.上海交通大学医学院附属同仁医院影像科,上海 200336
2.上海交通大学医学院附属同仁医院教学科,上海 200336
3.上海交通大学医学院附属同仁医院院长办公室,上海 200336
4.上海交通大学医学院附属瑞金医院科技发展处《诊断学理论与实践》编辑部,上海 200025
5.上海交通大学医学院附属瑞金医院放射科,上海 200025
6.上海交通大学医学院教务处,上海 200025
Yao Weiwu, Email: yaoweiwuhuan@163.com
Received:11 December 2024,
Published:20 June 2025
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钟京谕, 星月, 吕良靓, 等. 我国住院医师置信职业行为指标构建研究的系统评价[J]. 中华医学教育探索杂志, 2025, 24(6): 728-735.
Zhong Jingyu, Xing Yue, Lü Liangjing, et al. Research on the development of entrustable professional activity indicators for residents in China: a systematic review[J]. Chinese journal of medical education research, 2025, 24(6): 728-735.
钟京谕, 星月, 吕良靓, 等. 我国住院医师置信职业行为指标构建研究的系统评价[J]. 中华医学教育探索杂志, 2025, 24(6): 728-735. DOI: 10.3760/cma.j.cn116021-20241211-02056.
Zhong Jingyu, Xing Yue, Lü Liangjing, et al. Research on the development of entrustable professional activity indicators for residents in China: a systematic review[J]. Chinese journal of medical education research, 2025, 24(6): 728-735. DOI: 10.3760/cma.j.cn116021-20241211-02056.
目的
2
系统评价我国住院医师置信职业行为(entrustable professional activities,EPAs)指标构建研究现状。
方法
2
检索中国知网、万方数据、华艺学术、PubMed、Embase和Web of Science数据库中有关我国住院医师EPAs指标构建的文献,检索时限为2005年1月1日至2025年2月28日。2名研究者独立筛选文献、提取数据后,进行描述性分析;并依据乔安娜布里格斯研究所关于专家观点及共识的质量评价工具进行质量评价。定量数据以中位数(范围)表示,定性数据以频数(百分比)表示。
结果
2
共纳入8篇文献,构建了2个住院医师通用及6个专科的EPAs指标体系。研究的总体质量较高,不足主要与共识指标构建过程所使用的方法有关。研究招募的专家数量为22~45人,参与积极程度均为100.00%,权威系数高(0.820~0.914),协调系数高(0.157~0.741)。研究大多采用文献调研作为指标池来源之一(8项、100.00%),以德尔菲法达成共识(6项、75.00%)并给出指标纳入标准(7项、87.50%),但相关应用研究较少(1项、12.50%),无研究设定指标权重或开展质量评估。研究所构建的EPAs指标数量为10~38项,对标题(8项、100.00%)及在培训各个阶段所期待的置信等级(6项、75.00%)方面的报告相对完善,但其他方面的报告较为欠缺。所构建的专科EPAs指标中与通用EPAs指标重叠的占比为38.39%。
结论
2
我国住院医师EPAs指标构建研究处于起步阶段,方法学质量和报告完整性仍有提高空间。研究中专科和通用的EPAs指标的内容部分重复,未能完全体现专科特色。
Objective
2
To systematically evaluate the current status of research on the development of indicators for entrustable professional activities (EPAs) of residents in China.
Methods
2
We searched the China National Knowledge Infrastructure
Wanfang Data
Airiti Library
PubMed
Embase
and Web of Science databases for literature on the development of EPA indicators for residents in China published between January 1
2005 and February 28
2025. Two researchers independently screened the literature and extracted data
followed by descriptive analysis. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tool for expert opinion. Quantitative data were presented as medians (ranges) and qualitative data were presented as frequencies (percentages).
Results
2
A total of eight articles were included
in which two general EPA indicator systems and six specialty-specific EPA indicator systems were developed for residents. The overall quality of the research was high
with the main shortcomings related to the methods used in the process of constructing the consensus indicators. The number of experts recruited ranged from 22 to 45
with 100.00% response rate
high authority coefficients (0.820-0.914)
and high coordination coefficients (0.157-0.741). Most of the studies used literature reviews as one source for the indicator pool (8 studies
100.00%)
employed the Delphi method to reach consensus (6 studies
75.00%)
and provided inclusion criteria for the indicators (7 studies
87.50%). However
only one study (12.50%) explored the practical application of the developed indicators
and none of the studies set indicator weights or conducted quality assessments. The number of EPA indicators developed ranged from 10 to 38 per study. The reporting of EPA indicators was included in most studies regarding titles (8 studies
100.00%) and the expected levels of entrustment at various stages of training (6 studies
75.00%)
but the reporting on other aspects was lacking. Among the specialty-specific EPA indicators
38.39% overlapped with the general EPAs indicators.
Conclusions
2
The research on the development of EPA indicators for residents in China is still in its early stages
and there is room for improvement in methodological quality and reporting coverage. There is partial overlap between specialty-specific and general EPA indicators
failing to fully reflect the unique characteristics of different specialties.
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