基于置信职业行为的皮肤科住培医师胜任力评价的探索

付玉萍; 李琳娜; 田雪; 李珺; 高航; 孙健

doi:10.3760/cma.j.cn116021-20230620-01687

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基于置信职业行为的皮肤科住培医师胜任力评价的探索

教育评价 | 更新时间：2025-02-21

- 基于置信职业行为的皮肤科住培医师胜任力评价的探索
- Competency evaluation of dermatology physicians receiving residency training based on entrustable professional activities
- 中华医学教育探索杂志 2025年24卷第2期页码：198-203
- 作者机构：
  
  1.锦州医科大学附属第一医院皮肤科，锦州　121001
  2.锦州医科大学附属第一医院住培管理处，锦州　121001
  3.锦州医科大学附属第一医院教务处，锦州　121001
- 作者简介：
  
  孙健，Email：sunjian19720115@163.com
- 基金信息：
  
  2022年辽宁省教育科学“十四五”规划课题一般课题(JG22DB276);锦州医科大学研究生教育教学研究与改革项目(YJ2022-010);锦州医科大学教育教学研究与改革项目(YB2021031)
- DOI：10.3760/cma.j.cn116021-20230620-01687
  中图分类号： R75
- 收稿日期：2023-06-20，
  
  纸质出版日期：2025-02-20
- 稿件说明：
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付玉萍, 李琳娜, 田雪, 等. 基于置信职业行为的皮肤科住培医师胜任力评价的探索[J]. 中华医学教育探索杂志, 2025, 24(2): 198-203.

Fu Yuping, Li Linna, Tian Xue, et al. Competency evaluation of dermatology physicians receiving residency training based on entrustable professional activities[J]. Chinese journal of medical education research, 2025, 24(2): 198-203.
付玉萍, 李琳娜, 田雪, 等. 基于置信职业行为的皮肤科住培医师胜任力评价的探索[J]. 中华医学教育探索杂志, 2025, 24(2): 198-203. DOI： 10.3760/cma.j.cn116021-20230620-01687.

Fu Yuping, Li Linna, Tian Xue, et al. Competency evaluation of dermatology physicians receiving residency training based on entrustable professional activities[J]. Chinese journal of medical education research, 2025, 24(2): 198-203. DOI： 10.3760/cma.j.cn116021-20230620-01687.

摘要

目的

研究置信职业行为（entrustable professional activities，EPAs）在皮肤科住院医师胜任力评价中的应用效果，实践皮肤科住院医师EPAs胜任力的分层递进培养目标，以提升医师岗位的胜任力。

方法

采用问卷调查法，选取2019年9月至2022年9月在锦州医科大学附属第一医院皮肤科进行住院医师规范化培训的165名住院医师及8名指导教师作为研究对象，进行EPAs教师评价和医师自我评价。采用Kruskal-Wallis

检验和Mann-Whitney

检验，比较不同年资组皮肤科住培医师置信等级的差异。

结果

EPAs教师评价和医师自我评价结果随着住培医师年资的增加呈现出逐年增高的趋势。第三年住培医师（postgraduate year three，PGY3）组的EPAs教师评价和自我评价级别最高。各年资组在EPA4（治疗决策）、EPA8（危急重症识别与处置）、EPA14（临床教学）及EPA15（公共卫生事件应对）评分均偏低。各年资组间EPAs教师评价和自我评价Kruskal-Wallis

检验差异均具有统计学意义（

0.05）。教师评价PGY1和PGY2间、PGY1和PGY3间差异具有统计学意义（Bonferroni

值矫正，

0.05），PGY2和PGY3组间差异无统计学意义（

0.05）。

结论

不同年资组的皮肤科住培医师在EPAs评价上存在区分度，EPAs胜任力分层递进培养可以有效提升皮肤科住培医师的岗位胜任力。教师评价和自我评价分数之间的不一致性，提示未来需要改进反馈计划。

Abstract

Objective

To investigate the application effect of entrustable professional activities (EPAs) in competency evaluation of dermatology residents

to practice the goal of hierarchical progressive training for EPAs competency in dermatology residents

and to improve the competency of physicians.

Methods

A questionnaire survey was conducted among 8 clinical instructors and 165 residents who received standardized residency training in Department of Dermatology

The First Affiliated Hospital of Jinzhou Medical University

from September 2019 to September 2022

and self-assessment and trainer-assessment were performed based on EPAs. The Kruskal-Wallis

test and the Mann-Whitney

test were used for comparison of entrustable level between the dermatology residents of different grades.

Results

The scores of both trainer-assessment and self-assessment based on EPAs increased with the increase in the grade of the resident physicians

and the resident physicians of the third year (the PGY3 group) had the highest levels of trainer-assessment and self-assessment based on EPAs. The resident physicians of all grades showed relatively low assessment scores of EPA4 (making a medical decision)

EPA8 (recognize a patient requiring urgent or emergent care and initiate evaluation and management)

EPA14 (clinical teaching)

and EPA15 (public health events management). There were significant differences in all EPAs items of trainer-assessment and self-assessment between the residents of different grades (Kruskal-Wallis test

0.05). There was a significant difference in trainer-assessment between PGY1 and PGY2 and between PGY1 and PGY3 (Bonferroni

correction

0.05)

while there was no significant difference between the PGY2 and PGY

3 groups (

0.05).

Conclusions

There are differences in the evaluation of EPAs in dermatology residents of different grades

and hierarchical progressive training of EPAs competency can effectively improve the clinical competency of dermatology residents. Given the inconsistency between the scores of self-assessment and trainer-assessment

it is necessary to improve the feedback plan in the future.

关键词

Keywords

references

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