From the Department of Neurology (H.H.), University of Arizona, Tucson; Departments of Pediatrics (R.E.) and Neurology (E.T.), University of Minnesota, Minneapolis; Department of Neuroscience (D.B.), Herbert Wertheim College of Medicine, Florida International University, Miami; Department of Neurology (J.K.), Oregon Health & Science University, Portland; and Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL.
Neurology. 2018 Feb 13;90(7):326-332. doi: 10.1212/WNL.0000000000004947. Epub 2018 Jan 17.
Medical education is currently undergoing a paradigm shift from process-based to competency-based education, focused on measuring the desired competence of a physician. In an attempt to improve the assessment framework used for medical education, the concept of entrustable professional activities (EPAs) has gained traction. EPAs are defined as professional activities that can be entrusted to an individual in a clinical context. The Association of American Medical Colleges (AAMC) defined a set of 13 such EPAs to define the core of what all students should be able to do on day 1 of residency, regardless of specialty choice. The AAMC is currently piloting these EPAs with 10 medical schools to determine if EPAs can be used as a way to observe, measure, and entrust medical students with core clinical activities by the end of the clinical immersion experiences of the third year. The specialty of pediatrics is piloting the use of specialty-specific EPAs at 5 medical schools to assess readiness for transitions from medical school into pediatric residency training and practice. To date, no neurology-specific EPAs have been published for use in neurology clerkships or neurology residencies. This article introduces the concept of EPAs in the context of competency-based medical education and describes how EPAs might be relevant and applicable in neurologic education across the continuum. The Undergraduate Education Subcommittee of the American Academy of Neurology advocates for a proactive approach to incorporating core EPAs in undergraduate medical education and to considering an EPA-based specialty-specific assessment framework for neurology.
医学教育正从基于过程的教育模式向基于能力的教育模式转变,其重点在于衡量医生所需的能力。为了改进医学教育中使用的评估框架,可信赖的专业活动(EPAs)的概念逐渐受到关注。EPAs 被定义为可以在临床环境中委托给个人的专业活动。美国医学协会(AAMC)定义了一套 13 项 EPAs,旨在定义所有学生在住院医师实习期第一天无论选择何种专业都应具备的核心能力。AAMC 目前正在与 10 所医学院合作试行这些 EPA,以确定 EPA 是否可以作为一种观察、衡量和委托医学生进行核心临床活动的方式,这些活动将在第三年临床浸入体验结束时进行。儿科学专业正在 5 所医学院试行使用特定专业的 EPA,以评估从医学院过渡到儿科住院医师培训和实践的准备情况。迄今为止,还没有针对神经病学实习或住院医师培训的特定神经病学 EPA。本文将介绍基于能力的医学教育背景下的 EPA 概念,并描述 EPA 在神经科教育整个过程中的相关性和适用性。神经病学美国学院的本科教育小组委员会主张在本科医学教育中积极采用核心 EPA,并考虑为神经病学制定基于 EPA 的专科特定评估框架。