College of Anaesthesiologists of Ireland, 22 Merrion Square North, Dublin 2, D02 X236, Ireland.
Medical Education Consultant, Galway, H91 V2C9, Ireland.
Ir J Med Sci. 2020 Nov;189(4):1379-1389. doi: 10.1007/s11845-020-02216-4. Epub 2020 Apr 5.
The goal of the College of Anaesthesiologists of Ireland (CAI) is to train qualified anaesthesiologists who embody all aspects of professionalism. The Medical Council of Ireland has identified Eight Domains of Good Professional Practice which guide the standards for postgraduate specialist training, including within the CAI.
Entrustable Professional Activities (EPAs) were adopted as the organising framework for a competency-based programme within CAI. The aims were (i) to ensure that the EPA-integrated competencies from across the full range of domains and (ii) to design workplace-based assessment which fosters a culture and practice of feedback above and beyond technical skills.
Four core EPAs were developed for trialling; competencies were tagged to the eight domains in an iterative development process. Feedback Reports were devised as tools for workplace-based assessment. Analysis of the Feedback Report data revealed how well the content reflected the full range of domains.
'Clinical Skills' is the domain to which most competencies within the EPAs were tagged. Analysis of the content of Feedback Reports also revealed an overrepresentation of that domain. This highlighted the apparent preference of consultants and trainees for selecting clinical aspects of an EPA to provide and receive feedback on, rather than professionalism or any of the other non-technical domains.
We advocate and make recommendations for more effective incorporation of the non-technical domains of professional practice in the processes of curriculum development, teaching, learning, feedback and assessment.
爱尔兰麻醉师学院(CAI)的目标是培养体现专业精神各个方面的合格麻醉师。爱尔兰医学委员会确定了八项良好专业实践领域,这些领域指导研究生专科培训的标准,包括在 CAI 内。
可委托的专业活动(EPAs)被用作 CAI 内基于能力的计划的组织框架。目的是(i)确保从各个领域的 EPA 整合的能力,以及(ii)设计基于工作场所的评估,培养超越技术技能的反馈文化和实践。
开发了四项核心 EPA 进行试验;在迭代开发过程中,将能力标记到八个领域。反馈报告被设计为基于工作场所的评估工具。对反馈报告数据的分析揭示了内容如何很好地反映了整个领域的范围。
“临床技能”是 EPA 内大多数能力所标记的领域。对反馈报告内容的分析也显示出该领域的代表性过高。这突出表明顾问和学员显然更倾向于选择 EPA 的临床方面提供和接收反馈,而不是专业精神或任何其他非技术领域。
我们提倡并提出建议,在课程开发、教学、学习、反馈和评估过程中,更有效地纳入专业实践的非技术领域。