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置信职业行为在临床医学本科生全科实习中的应用和评价
Application and evaluation of entrustable professional activities in the general practice internship of clinical medicine undergraduates
- 中华医学教育探索杂志 2025年24卷第6期 页码：736-743
- 作者机构：
1.上海交通大学医学院附属仁济医院全科医学科，上海 200127
2.上海交通大学医学院附属仁济医院上海-渥太华联合医学院，上海 200127
3.上海浦东新区潍坊社区卫生服务中心，上海 200122
4.上海交通大学医学院附属仁济医院临床医学院，上海 200127
5.上海交通大学医学院附属仁济医院国际交流办公室，上海 200127
6.上海交通大学医学院教务处，上海 200025
- 作者简介：
邵莉，Email：drshaoli@shsmu.edu.cn
- 基金信息：基于置信职业行为（EPAs）的临床教学评估体系的建设(沪教委高（2020）55号);上海交通大学医学院毕业后医学教育培训与管理创新项目(BYH20210409;BYH20220101;BYH20240108);上海市高等教育学会(2QYB24087)
DOI：10.3760/cma.j.cn116021-20250201-02062
中图分类号： R-05收稿日期：2025-02-01，
纸质出版日期：2025-06-20
- 稿件说明：
移动端阅览
孟超, 郦忆, 徐霞凤, 等. 置信职业行为在临床医学本科生全科实习中的应用和评价[J]. 中华医学教育探索杂志, 2025, 24(6): 736-743.
Meng Chao, Li Yi, Xu Xiafeng, et al. Application and evaluation of entrustable professional activities in the general practice internship of clinical medicine undergraduates[J]. Chinese journal of medical education research, 2025, 24(6): 736-743.
孟超, 郦忆, 徐霞凤, 等. 置信职业行为在临床医学本科生全科实习中的应用和评价[J]. 中华医学教育探索杂志, 2025, 24(6): 736-743. DOI： 10.3760/cma.j.cn116021-20250201-02062.
Meng Chao, Li Yi, Xu Xiafeng, et al. Application and evaluation of entrustable professional activities in the general practice internship of clinical medicine undergraduates[J]. Chinese journal of medical education research, 2025, 24(6): 736-743. DOI： 10.3760/cma.j.cn116021-20250201-02062.
摘要
目的
2
评价置信职业行为（entrustable professional activities，EPAs）框架在临床医学本科生全科实习中的应用效果，以发现实习中需要改进的问题，提升医学生的胜任力。
方法
2
选取2021年10月至2023年10月在上海交通大学医学院附属仁济医院全科实习的2018级和2019级临床医学专业五年制（英文班）共75名学生为研究对象，采用核心EPAs的设计，对EPAs各维度进行相关性评价及达标情况分析。
结果
2
EPAs评价结果显示EPA2（践行尊重、理解与团队合作）的平均成绩为9.33，得分最高，EPA10（慢病管理和重点人群管理）平均成绩8.08，得分最低；按照置信等级赋值，以3a以上为达标要求，学生EPAs的置信等级集中在3a和3b，达标率最高的是EPA2（践行尊重、理解与团队合作）为85.33%，其次是EPA1（遵守行规，体现职业素养）为80.00%，第三是EPA8（查阅资料，解决临床问题）为72.00%；达标率最低的是EPA10（慢病管理及重点人群管理）仅为33.33%，EPA4（分析判读检查结果）次之，达标率为57.33%。
结论
2
EPAs将胜任力评价具体化，能很好地体现涵盖知识、技能、价值观和态度等多个要素“胜任力导向”的培训目标，且具有专业特点。本科生在职业素养和学术领域有着比较好的优势，但在社区慢病管理及重点人群管理方面有所欠缺，提示需要加强健康与社会领域的锻炼，以适应与住院医师规范化培训阶段的能力衔接。
Abstract
Objective
2
To evaluate the effectiveness of entrustable professional activities (EPAs) in the general practice internship of undergraduate clinical medicine students
identify issues that need improvement in the internship
and enhance medical students' competence.
Methods
2
A total of 75 students in the five-year (English class) clinical medicine program enrolled in 2018 and 2019 who participated in general practice internship in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2021 to October 2023 were selected as study subjects. The design of core EPAs was adopted to assess the correlation among different EPA dimensions and to analyze the qualified rates.
Results
2
The evaluation of EPAs showed that EPA2 (practicing respect
understanding and teamwork) had the highest mean score of 9.33
and EPA10 (chronic disease management and management of key populations) had the lowest mean score of 8.08. A supervision level of 3a and above was used as the criterion for qualification. The supervision levels of the students' EPAs were mostly concentrated at levels 3a and 3b. The highest qualified rate was for EPA2 (practicing respect
understanding and teamwork) at 85.33%
followed by EPA1 (complying with the rules of the profession and demonstrating professionalism) at 80.00% and EPA8 (reviewing information and solving clinical problems) at 72.00%. The lowest qualified rate was for EPA10 (chronic disease management and management of key populations) at 33.33%
followed by EPA4 (analyzing and interpreting test results) at 57.33%.
Conclusions
2
EPAs concretize competency evaluation
which can effectively reflect the "competency-oriented" training objectives encompassing multiple elements such as knowledge
skills
values
and attitudes
while maintaining professional specificity. Undergraduates demonstrated strengths in professionalism and academics
but showed deficiencies in community chronic disease management and management of key populations. These findings suggest the need to strengthen the training in health and social care to better align with the competencies required during standardized residency training.
关键词
Keywords
references
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