Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Pain Symptom Manage. 2017 Oct;54(4):609-616.e1. doi: 10.1016/j.jpainsymman.2017.07.003. Epub 2017 Jul 17.
Entrustable Professional Activities (EPAs) represent the key physician tasks of a specialty. Once a trainee demonstrates competence in an activity, they can then be "entrusted" to practice without supervision. A physician workgroup of the American Academy of Hospice and Palliative Medicine sought to define Hospice and Palliative Medicine (HPM) EPAs.
The objective of this study was to describe the development of a set of consensus EPAs for HPM fellowship training in the United States.
A set of HPM EPAs was developed through an iterative consensus process involving an expert workgroup, vetting at a national meeting with HPM educators, and an electronic survey from a national registry of 3550 HPM physicians. Vetting feedback was reviewed, and survey data were statistically analyzed. Final EPA revisions followed from the multisource feedback.
Through the iterative consensus process, a set of 17 HPM EPAs was created, detailed, and revised. In the national survey, 362 HPM specialists responded (10%), including 58 of 126 fellowship program directors (46%). Respondents indicated that the set of 17 EPAs well represented the core activities of HPM physician practice (mean 4.72 on a five-point Likert scale) and considered all EPAs to either be "essential" or "important" with none of the EPAs ranking "neither essential, nor important."
A set of 17 EPAs was developed using national input of practicing physicians and program directors and an iterative expert workgroup consensus process. The workgroup anticipates that EPAs can assist fellowship directors with strengthening competency-based training curricula.
可委托的专业活动（EPAs）代表了专业医师的关键任务。一旦受训者在某项活动中表现出能力，他们就可以“被委托”在没有监督的情况下进行实践。美国姑息医学协会的一个医师工作组试图定义姑息医学（HPM）的 EPAs。
本研究的目的是描述在美国为姑息医学住院医师培训制定一套共识 EPA 的过程。
通过一个专家工作组的迭代共识过程、在全国会议上对姑息医学教育者进行审查以及对全国 3550 名姑息医学医生的国家登记处进行电子调查，制定了一套 HPM EPA。审查反馈意见，并对调查数据进行统计分析。最后从多源反馈中对 EPA 进行修订。
通过迭代共识过程，创建、详细制定并修订了一套 17 项 HPM EPA。在全国性调查中，362 名姑息医学专家做出了回应（10%），其中包括 126 个住院医师项目主任中的 58 名（46%）。受访者表示，这 17 项 EPA 很好地代表了姑息医学医师实践的核心活动（五分制量表上的平均得分为 4.72），并认为所有 EPA 要么“必不可少”，要么“重要”，没有一项 EPA 被评为“既不重要，也不重要”。
使用实践医生和项目主任的全国性投入以及迭代专家工作组共识过程，制定了一套 17 项 EPA。工作组预计 EPA 可以帮助住院医师培训主任加强基于能力的培训课程。
