Institute of Anaesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Zurich University of Applied Sciences, School of Management and Law, Winterthur, Switzerland.
Br J Anaesth. 2020 Jul;125(1):98-103. doi: 10.1016/j.bja.2020.04.009. Epub 2020 May 16.
Entrustable professional activities (EPAs) are commonly developed by senior clinicians and education experts. However, if postgraduate training is conceptualised as an educational alliance, the perspective of trainees should be included. This raises the question as to whether the views of trainees and supervisors on entrustability of specific EPAs differ, which we aimed to explore.
A working group, including all stakeholders, selected and drafted 16 EPAs with the potential for unsupervised practice within the first year of training. For each EPA, first-year trainees, advanced trainees, and supervisors decided whether it should be possible to attain trust for unsupervised practice by the end of the first year of anaesthesiology training (i.e. whether the respective EPA qualified as a 'first-year EPA').
We surveyed 23 first-year trainees, 47 advanced trainees, and 51 supervisors (overall response rate: 68%). All groups fully agreed upon seven EPAs as 'first-year EPAs' and on four EPAs that should not be entrusted within the first year. For all five remaining EPAs, a significantly higher proportion of first-year trainees thought these should be entrusted as first-year EPAs compared with advanced trainees and supervisors. We found no differences between advanced trainees and supervisors.
The views of first-year trainees, advanced trainees, and supervisors showed high agreement. Differing views of young trainees disappeared after the first year. This finding provides a fruitful basis to involve trainees in negotiations of autonomy.
可委托的专业活动（EPAs）通常由资深临床医生和教育专家制定。然而，如果将研究生培训视为教育联盟，就应该包括学员的观点。这就提出了一个问题，即学员和主管人员对具体 EPAs 的可委托性的看法是否存在差异，我们旨在探讨这一问题。
一个由所有利益相关者组成的工作组选择并起草了 16 项具有在培训第一年进行独立实践潜力的 EPA。对于每项 EPA，第一年的学员、高级学员和主管人员决定是否有可能在麻醉学培训的第一年结束时获得独立实践的信任（即，相应的 EPA 是否符合“第一年 EPA”的标准）。
我们调查了 23 名第一年的学员、47 名高级学员和 51 名主管人员（总体响应率为 68%）。所有组都完全同意 7 项 EPA 为“第一年 EPA”，并同意另外 4 项 EPA 不应在第一年委托。对于所有其余的 5 项 EPA，第一年的学员认为这些应该作为第一年 EPA 委托的比例明显高于高级学员和主管人员。我们没有发现高级学员和主管人员之间的差异。
第一年的学员、高级学员和主管人员的观点高度一致。年轻学员的不同观点在第一年之后消失了。这一发现为让学员参与自主协商提供了有益的基础。
