Pugh Debra, Cavalcanti Rodrigo B, Halman Samantha, Ma Irene W Y, Mylopoulos Maria, Shanks David, Stroud Lynfa
J Grad Med Educ. 2017 Apr;9(2):209-214. doi: 10.4300/JGME-D-16-00282.1.
The entrustable professional activity (EPA) framework has been identified as a useful approach to assessment in competency-based education. To apply an EPA framework for assessment, essential skills necessary for entrustment to occur must first be identified.
Using an EPA framework, our study sought to (1) define the essential skills required for entrustment for 7 bedside procedures expected of graduates of Canadian internal medicine (IM) residency programs, and (2) develop rubrics for the assessment of these procedural skills.
An initial list of essential skills was defined for each procedural EPA by focus groups of experts at 4 academic centers using the nominal group technique. These lists were subsequently vetted by representatives from all Canadian IM training programs through a web-based survey. Consensus (more than 80% agreement) about inclusion of each item was sought using a modified Delphi exercise. Qualitative survey data were analyzed using a framework approach to inform final assessment rubrics for each procedure.
Initial lists of essential skills for procedural EPAs ranged from 10 to 24 items. A total of 111 experts completed the national survey. After 2 iterations, consensus was reached on all items. Following qualitative analysis, final rubrics were created, which included 6 to 10 items per procedure.
These EPA-based assessment rubrics represent a national consensus by Canadian IM clinician educators. They provide a practical guide for the assessment of procedural skills in a competency-based education model, and a robust foundation for future research on their implementation and evaluation.
可委托专业活动（EPA）框架已被视为基于能力的教育中一种有用的评估方法。要应用EPA框架进行评估，首先必须确定委托发生所需的基本技能。
本研究使用EPA框架，旨在（1）确定加拿大内科住院医师培训项目毕业生应掌握的7种床边操作委托所需的基本技能，以及（2）制定这些操作技能的评估量表。
4个学术中心的专家焦点小组使用名义小组技术为每个操作EPA确定了基本技能的初始清单。随后，所有加拿大内科培训项目的代表通过网络调查对这些清单进行了审核。使用改良的德尔菲法寻求对每个项目纳入的共识（超过80%的同意率）。使用框架方法对定性调查数据进行分析，为每个操作制定最终评估量表提供依据。
操作EPA的基本技能初始清单包含10至24项。共有111名专家完成了全国性调查。经过两轮迭代，所有项目均达成了共识。经过定性分析，创建了最终量表。每个操作的最终量表包含6至10项。
这些基于EPA的评估量表代表了加拿大内科临床教师的全国共识。它们为基于能力的教育模式下的操作技能评估提供了实用指南，并为其实施和评估的未来研究奠定了坚实基础。
