Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
Department of Nephrology, Nagoya University Hospital, Nagoya, Japan.
BMJ Open. 2021 Aug 4;11(8):e047923. doi: 10.1136/bmjopen-2020-047923.
Training strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions.
Purposive design and a modified Delphi method to build consensus.
The department of nephrology in a university hospital in Aichi Prefecture, Japan.
Based on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD <1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated.
An initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure.
The concept of EPAs enabled us to develop goals and evaluation criteria for residents' training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.
关于可委托专业活动（EPAs）的培训策略因国家而异；其中一种策略是针对住院医师的。然而，目前还没有关于轮转至肾病科的住院医师制定的 EPAs 的报道。我们旨在构建此类 EPA，可以将其推广到其他机构。
有目的的设计和修改后的 Delphi 方法来达成共识。
日本爱知县一所大学医院的肾病科。
基于我们科室的达标目标，研究小组内部制定了一份初始清单。专家小组由来自我们附属医院的 25 名肾病学家组成。专家们根据 5 分制进行回复，如果满足以下两个条件（A）和（B），则达成共识：（A）平均值≥4，标准差<1；（B）超过 75%的回复者将项目评为 4 或更高。达成一致后，该项目将进入下一轮。此轮重复进行。
制定了一份包含 11 项内容的初始清单；经过三轮 Delphi 调查和修订，留下了 8 项最终作为 EPAs。这些项目可以作为轮转至肾病科的住院医师需要达到的目标清单。结果表明，大多数专家认为住院医师应该能够执行所有医生认为必要或紧急的任务，例如处理高钾血症和心力衰竭的任务。
EPAs 的概念使我们能够为肾病学住院医师的培训制定目标和评估标准。本研究可以为未来的讨论提供基础，并为肾病学住院医师教育的发展做出贡献。
