Favreau Michele A, Tewksbury Linda, Lupi Carla, Cutrer William B, Jokela Janet A, Yarris Lalena M
M.A. Favreau is associate professor of pediatrics, and adjunct associate professor, Division of Management, Oregon Health and Science University School of Medicine, Portland, Oregon. She was also associate dean for professional development and lifelong learning, Oregon Health and Science University School of Medicine, Portland, Oregon, at the time this work was done. L. Tewksbury is associate dean for student affairs and associate professor of pediatrics, New York University School of Medicine, New York, New York. C. Lupi is assistant dean for learning and teaching and professor of obstetrics and gynecology, Florida International University Herbert Wertheim College of Medicine, Miami, Florida. W.B. Cutrer is assistant professor of pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee. J.A. Jokela is professor and head, Department of Medicine, University of Illinois College of Medicine at Urbana-Champaign, Urbana, Illinois. L.M. Yarris is associate professor of emergency medicine and program director for emergency medicine, Oregon Health and Science University School of Medicine, Portland, Oregon.
Acad Med. 2017 Jun;92(6):759-764. doi: 10.1097/ACM.0000000000001511.
In 2014, the Association of American Medical Colleges identified 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs), which are activities that entering residents might be expected to perform without direct supervision. This work included the creation of an interinstitutional concept group focused on faculty development efforts, as the processes and tools for teaching and assessing entrustability in undergraduate medical education (UME) are still evolving. In this article, the authors describe a conceptual framework for entrustment that they developed to better prepare all educators involved in entrustment decision making in UME. This framework applies to faculty with limited or longitudinal contact with medical students and to those who contribute to entrustment development or render summative entrustment decisions.The authors describe a shared mental model for entrustment that they developed, based on a critical synthesis of the EPA literature, to serve as a guide for UME faculty development efforts. This model includes four dimensions for Core EPA faculty development: (1) observation skills in authentic settings (workplace-based assessments), (2) coaching and feedback skills, (3) self-assessment and reflection skills, and (4) peer guidance skills developed through a community of practice. These dimensions form a conceptual foundation for meaningful faculty participation in entrustment decision making.The authors also differentiate between the UME learning environment and the graduate medical education learning environment to highlight distinct challenges and opportunities for faculty development in UME settings. They conclude with recommendations and research questions for future Core EPA faculty development efforts.
2014年，美国医学院协会确定了13项进入住院医师培训阶段的核心可托付专业活动（Core EPAs），这些活动是预期进入住院医师培训阶段的人员在没有直接监督的情况下可能会执行的活动。这项工作包括成立一个跨机构概念小组，专注于教师发展工作，因为本科医学教育（UME）中教学和评估可托付性的流程和工具仍在不断发展。在本文中，作者描述了一个他们开发的可托付性概念框架，以便更好地让所有参与UME可托付性决策的教育工作者做好准备。该框架适用于与医学生接触有限或长期接触的教师，以及那些为可托付性发展做出贡献或做出总结性可托付性决策的教师。作者描述了一个他们基于对EPA文献的批判性综合而开发的可托付性共享心智模型，作为UME教师发展工作的指南。这个模型包括Core EPA教师发展的四个维度：（1）在真实环境中的观察技能（基于工作场所的评估），（2）指导和反馈技能，（3）自我评估和反思技能，以及（4）通过实践社区发展的同伴指导技能。这些维度为教师有意义地参与可托付性决策奠定了概念基础。作者还区分了UME学习环境和毕业后医学教育学习环境，以突出UME环境中教师发展面临的独特挑战和机遇。他们最后提出了未来Core EPA教师发展工作的建议和研究问题。
