基于置信职业行为的腹腔镜技能考评体系构建与验证

梁垚; 赵百伟; 李瑭; 谭裕宝; 黄婉; 张昆松; 匡铭

doi:10.3760/cma.j.cn116021-20250211-02055

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基于置信职业行为的腹腔镜技能考评体系构建与验证

置信职业行为研究 | 更新时间：2025-07-01

- 基于置信职业行为的腹腔镜技能考评体系构建与验证
- Construction and validation of a laparoscopic skills assessment system based on entrustable professional activities
- 中华医学教育探索杂志 2025年24卷第6期页码：751-756
- 作者机构：
  
  1.华南恶性肿瘤防治全国重点实验室/广东省恶性肿瘤临床医学研究中心/中山大学肿瘤防治中心胃外科，广州 510060
  2.中山大学肿瘤防治中心科教处临床技能培训中心，广州 510060
  3.中山大学附属第一医院肝胆胰外科中心，广州 510080
  4.中山大学中山医学院，广州 510080
- 作者简介：
  
  匡铭，Email：kuangmingsysu@163.com
- 基金信息：
  
  美国中华医学基金会教育创新项目(22-493)
- DOI：10.3760/cma.j.cn116021-20250211-02055
  中图分类号： R-615
- 收稿日期：2025-02-11，
  
  纸质出版日期：2025-06-20
- 稿件说明：
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梁垚, 赵百伟, 李瑭, 等. 基于置信职业行为的腹腔镜技能考评体系构建与验证[J]. 中华医学教育探索杂志, 2025, 24(6): 751-756.

Liang Yao, Zhao Baiwei, Li Tang, et al. Construction and validation of a laparoscopic skills assessment system based on entrustable professional activities[J]. Chinese journal of medical education research, 2025, 24(6): 751-756.
梁垚, 赵百伟, 李瑭, 等. 基于置信职业行为的腹腔镜技能考评体系构建与验证[J]. 中华医学教育探索杂志, 2025, 24(6): 751-756. DOI： 10.3760/cma.j.cn116021-20250211-02055.

Liang Yao, Zhao Baiwei, Li Tang, et al. Construction and validation of a laparoscopic skills assessment system based on entrustable professional activities[J]. Chinese journal of medical education research, 2025, 24(6): 751-756. DOI： 10.3760/cma.j.cn116021-20250211-02055.

摘要

目的

基于置信职业行为（entrustable professional activities，EPAs），构建并验证胜任力导向的腹腔镜技能ECM考评体系（ECM system for assessment of laparoscopic skills，ESALS）。

方法

成立由5家医疗机构15名成员组成的研究小组，以腹腔镜技能阶段式培训课程（staged training and assessment of laparoscopic skills，STALS）为EPAs蓝本，综合运用范围综述、行为事件访谈和K-J法构建ESALS。对49名学员和10名专科医师（包括5名新手和5名专家）分别进行基础技能和高级技能评价，并与基础腹腔镜技能训练评估（training and assessment of basic laparoscopic techniques，TABLT）和全球腹腔镜手术技能评估（global operative assessment of laparoscopic skills，GOALS）等评估工具对比分析。运用SPSS 23.0软件进行Mann-Whitney

检验，相关性分析采用Spearman系数。

结果

纳入13篇文献，访谈10名高级职称外科医师，构建了包含10项置信行为、8个维度胜任力特征和5个置信级别的ESALS。基础技能评价中，ESALS与TABLT评分显著正相关（

=0.881，

0.001）；高级技能评价中，新手组与专家组在ESALS各项胜任力评分上差异有统计学意义（

0.05），但GOALS评分显示两组在组织处理能力方面差异无统计学意义。

结论

ESALS评价全面、标准精细、反馈精准，评估效能不劣于经典工具。未来需扩大样本量验证其普适性，并开发电子化工具提升应用效率。

Abstract

Objective

To construct and validate a competency-oriented entrustable professional activities (EPAs)-Competency-Milestones system for assessment of laparoscopic skills (ESALS).

Methods

A research team composed of 15 members from five medical institutions was established. Taking the Staged Training and Assessment of Laparoscopic Skills program as the basis for EPAs

ESALS was constructed through scoping review and behavioral event interviews and the use of the Kawakita Jiro method. ESALS was applied to evaluate 49 trainees and 10 specialists (including 5 novices and 5 experts) on basic and advanced laparoscopic skills

respectively

in comparison with two other assessment tools—the Training and Assessment of Basic Laparoscopic Techniques (TABLT) and the Global Operative Assessment of Laparoscopic Skills (GOALS). Perform Mann Whitney U test using SPSS 23.0 software

and use Spearman coefficient for correlation analysis.

Results

Through reviewing 13 literuature articles and interviewing 10 senior sur

geons

the ESALS was developed

comprising 10 EPAs

8 dimensions of competency characteristics

and 5 entrustable levels. In the basic skills evaluation

the ESALS score was significantly positively correlated with the TABLT score (

=0.881

0.001). In the advanced skills evaluation

significant differences were observed between the novice and expert groups in all the ESALS competency scores (all

0.05)

while no difference was detected in the GOALS score of tissue handling ability.

Conclusions

ESALS provides comprehensive evaluation

detailed standards

and precise feedback

with comparable efficacy to conventional tools. Future work should focus on expanding sample size to verify its generalizability and developing an electronic tool to enhance application efficiency.

关键词

Keywords

references

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