University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Acad Psychiatry. 2020 Feb;44(1):37-45. doi: 10.1007/s40596-019-01142-7. Epub 2019 Nov 15.
Entrustable professional activities (EPAs) represent discrete clinical tasks that can be entrusted to trainees in psychiatry. They are increasingly being used as educational framework in several countries. However, the empirical evidence available has not been synthesized in the field of psychiatry. Therefore, the authors conducted a systematic review in order to summarize and evaluate the available evidence in the field of EPAs in undergraduate and graduate medical education in psychiatry.
The authors searched PubMed, Cochrane Library, ERIC, Embase, PsycINFO, all Ovid journals, Scopus, Web of Science, MedEdPORTAL, and the archives of Academic Psychiatry for articles reporting quantitative and qualitative research as well as educational case reports on EPAs in undergraduate and graduate psychiatry education published since 2005. All included articles were assessed for content (development, implementation, and assessment of EPAs) and quality using the Quality Assessment Tool for Studies with Diverse Designs.
The authors screened 2807 records and included a total of 20 articles in the final data extraction. Most studies were expert consensus reports (n = 6, 30%) and predominantly conducted in English-speaking countries (n = 17, 85%). Papers reported mainly EPA development and/or EPA implementation studies (n = 14, 70%), whereas EPA assessment studies were less frequent (n = 6, 30%). Publications per year showed an increasing trend both in quantity (from 1 in 2011 to 7 in 2018) and quality (from a QATSDD score of 27 in 2011 to an average score of 39 in 2018). The main focus of the articles was the development of individual EPAs for different levels of training for psychiatry or on curricular frameworks based on EPAs in psychiatry (n = 10, 50%). The lack of empirical controlled studies does currently not allow for meta-analyses of educational outcomes.
The concept of EPA-based curricula seems to become increasingly present, a focus in the specialty of psychiatry both in UME and GME. The lack of empirical research in this context is an important limitation for educational practice recommendations. Currently there is only preliminary but promising data available for using EPAs with regard to educational outcomes. EPAs seem to be effectively used from a curriculum design perspective for UME and GME in psychiatry.
可委托的专业活动（EPAs）代表可以委托给精神病学学员的离散临床任务。它们越来越多地被用作几个国家的教育框架。然而，现有的实证证据尚未在精神病学领域得到综合。因此，作者进行了系统综述，以总结和评估精神病学本科和研究生医学教育中 EPA 的现有证据。
作者检索了 PubMed、Cochrane 图书馆、ERIC、Embase、PsycINFO、所有 Ovid 期刊、Scopus、Web of Science、MedEdPORTAL 和学术精神病学档案，以查找自 2005 年以来报告本科和研究生精神病学教育中 EPA 的定量和定性研究以及教育案例报告的文章。所有纳入的文章均使用多元化设计研究质量评估工具评估其内容（EPA 的开发、实施和评估）和质量。
作者筛选了 2807 条记录，最终数据提取共纳入 20 篇文章。大多数研究是专家共识报告（n = 6，30%），主要来自英语国家（n = 17，85%）。论文主要报告了 EPA 开发和/或 EPA 实施研究（n = 14，70%），而 EPA 评估研究较少（n = 6，30%）。每年的出版物数量都呈现出增长趋势，无论是在数量（从 2011 年的 1 篇增加到 2018 年的 7 篇）还是在质量（从 2011 年的 QATSDD 评分 27 分提高到 2018 年的平均评分 39 分）方面。文章的主要重点是为精神病学的不同培训水平开发个别 EPA，或基于精神病学 EPA 的课程框架（n = 10，50%）。目前缺乏实证对照研究，不允许对教育成果进行荟萃分析。
基于 EPA 的课程概念似乎越来越受到关注，无论是在本科还是研究生医学教育中，都是精神病学专业的重点。这种情况下缺乏实证研究是对教育实践建议的一个重要限制。目前，关于使用 EPA 对教育成果的影响，只有初步但有希望的数据。从课程设计的角度来看，EPA 似乎可以有效地用于精神病学的本科和研究生医学教育。
