Institute of Medical Education, Peking University, Beijing, China.
National Center for Health Professions Education Development, Peking University, Beijing, China.
Med Educ Online. 2021 Dec;26(1):1981198. doi: 10.1080/10872981.2021.1981198.
The purpose of this scoping review is to update the recent progress of EPAs research in GME, focusing on the topical concern of EPAs effectiveness, and to provide a reference for medical researchers in countries/regions interested in introducing EPAs. Guided by Arksey and O'Malley's framework regarding scoping reviews, the researchers, in January 2021, conducted a search in five databases to ensure the comprehensiveness of the literature. After the predetermined process, 29 articles in total were included in this study. The most common areas for the implementation and evaluation of EPAs were Surgery (n = 7,24.1%), Pediatric (n = 5,17.2%) and Internal medicine (n = 4,13.8%), a result that shows a relatively large change in the research trend of EPAs in the last two years. Prior to 2018, EPAs research focused on internal medicine, psychiatry, family medicine, and primary care. The articles in the category of EPAs implementation and evaluation had four main themes: (1) validation of EPAs (n = 16,55.2%); (2) describing the experience of implementing EPAs (n = 11,37.9%); (3) examining the factors and barriers that influence the implementation and evaluation of EPAs (n = 6,20.6%); and (4) researching the experiences of faculty, interns, and other relevant personnel in using EPAs. Training programs were the most common EPAs implementation setting (n = 26,89.6%); direct observation and evaluation (n = 12,41.4%), and evaluation by scoring reports (n = 5,17.2%) were the two most common means of assessing physicians' EPA levels; 19 papers (65.5%) used faculty evaluation, and nine of these papers also used self-assessment (31.0%); the most frequently used tools in the evaluation of EPAs were mainly researcher-made instruments (n = 37.9%), assessment form (n = 7,24.1%), and mobile application (n = 6,20.7%). Although EPAs occupy an increasingly important place in international medical education, this study concludes that the implementation and diffusion of EPAs on a larger scale is still difficult.
本范围综述的目的是更新医学教育中职业成熟度评估（EPA）研究的最新进展，重点关注 EPA 有效性这一热门话题，并为有兴趣引入 EPA 的国家/地区的医学研究人员提供参考。本研究以 Arksey 和 O'Malley 的范围综述框架为指导，于 2021 年 1 月在五个数据库中进行了检索，以确保文献的全面性。经过预定的流程，共有 29 篇文章纳入本研究。EPA 实施和评估最常见的领域是外科（n=7，24.1%）、儿科（n=5，17.2%）和内科（n=4，13.8%），这表明 EPA 研究趋势在过去两年中发生了较大变化。2018 年之前，EPA 研究集中在内科、精神病学、家庭医学和初级保健。EPA 实施和评估类别的文章有四个主要主题：（1）EPA 的验证（n=16，55.2%）；（2）描述实施 EPA 的经验（n=11，37.9%）；（3）考察影响 EPA 实施和评估的因素和障碍（n=6，20.6%）；（4）研究教师、实习生和其他相关人员使用 EPA 的经验。培训计划是最常见的 EPA 实施环境（n=26，89.6%）；直接观察和评估（n=12，41.4%）以及评分报告评估（n=5，17.2%）是评估医生 EPA 水平的两种最常见方法；19 篇论文（65.5%）使用教师评估，其中 9 篇论文还使用自我评估（31.0%）；在 EPA 评估中使用最频繁的工具主要是研究人员自制工具（n=37.9%）、评估表（n=7，24.1%）和移动应用（n=6，20.7%）。尽管 EPA 在国际医学教育中占据越来越重要的地位，但本研究得出结论，EPA 的实施和更广泛的推广仍然困难重重。
