Lee Chen-Wei, Chen Guan-Liang, Yu Mei-Ju, Cheng Po-Liang, Lee Yi-Kung
Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan Department of Emergency Medicine Chiayi Taiwan.
National Chung Cheng University Center for Innovative Research on Aging Society Chiayi Taiwan.
J Acute Med. 2021 Jun 1;11(2):39-48. doi: 10.6705/j.jacme.202106_11(2).0001.
This study adopts the Situation-Behavior-Impact-Action (SBIA) model to examine the compliance of narrative feedback in the Entrustable Professional Activities (EPAs)-based e-Portfolio system for clinical preceptors in the emergency department of a regional teaching hospital, and analyzes the applicability of its application in emergency clinical training to increase the feasibility of improving the quality of clinical preceptors' feedback content.
Application of data mining technique to analyze 928 data points was recorded by 14 clinical teachers from April 2017 to May 2019. These data points were narrative feedback from workplace direct observation, which was recorded in the EPAs-based e-Portfolio.
The majority of the narrative feedback consisted of only one component, behavior observed (53.99%) and action suggestion (17.24%). Some feedback consisted of two to three components; which were behavior observed-action suggestion (20.37%) and situation description-behavior observed- action suggestion (1.29%). Only a few feedbacks consisted of all four components: situation description- behavior observed-possible impact-action suggestion (0.75%).
The current narrative feedback is from the basic appearance of SBIA, but there still got room for improvement. The narrative feedback should be given according to SBIA model in order to provide a comprehensive and constructive learning outcome. The narrative feedback recorded in EPAsbased e-Portfolio provides the delay of feedback effect. Thus, multiple feedbacks from various clinical teachers could make the assessments more concrete and outline the authentic clinical condition of the trainees.
本研究采用情境-行为-影响-行动(SBIA)模型,检验某地区教学医院急诊科临床带教教师基于可托付专业活动(EPA)的电子档案系统中叙事性反馈的依从性,并分析其在急诊临床培训中的适用性,以提高临床带教教师反馈内容质量的可行性。
应用数据挖掘技术分析14名临床教师在2017年4月至2019年5月期间记录的928个数据点。这些数据点是来自工作场所直接观察的叙事性反馈,记录在基于EPA的电子档案中。
大多数叙事性反馈仅包含一个部分,即观察到的行为(53.99%)和行动建议(17.24%)。一些反馈包含两到三个部分,即观察到的行为-行动建议(20.37%)和情境描述-观察到的行为-行动建议(1.29%)。只有少数反馈包含所有四个部分:情境描述-观察到的行为-可能的影响-行动建议(0.75%)。
当前的叙事性反馈处于SBIA的基本形式,但仍有改进空间。应根据SBIA模型给出叙事性反馈,以提供全面且具建设性的学习成果。记录在基于EPA的电子档案中的叙事性反馈存在反馈效果延迟的问题。因此,来自不同临床教师的多次反馈可以使评估更加具体,并勾勒出学员真实的临床情况。