Department of Radboudumc Health Academy, Postbus 9101, 6500, HB, Nijmegen, The Netherlands.
Department of Primary and Community Care, Radboudumc, Nijmegen, the Netherlands.
BMC Med Educ. 2022 Jan 20;22(1):48. doi: 10.1186/s12909-022-03116-0.
Entrustable professional activities (EPAs) are widely used in medical education, and they might be an important incentive to stimulate professional identity formation (PIF) of medical students, by actively encouraging participation in the workplace. The goal of this study was to explore the effects of an EPA-based curriculum on the PIF of medical students in undergraduate curricula.
In this study at the Radboud University Medical Center in Nijmegen, the Netherlands, the authors interviewed twenty-one medical students in three focus group interviews (November 2019), and conducted a thematic analysis based on both the synthesizing concepts PIF, communities of practice and EPAs, and newly defined themes.
Four central themes proved crucial for understanding the influence of EPAs on PIF: creating learning opportunities, managing feedback, dealing with supervision in context and developing confidence. EPAs helped students to create learning opportunities and to choose activities purposefully, and the use of EPAs stimulated their feedback-seeking behavior. The context and way of supervision had a great impact on their development, where some contexts offer better learning opportunities than others. EPAs helped them develop trust and self-confidence, but trust from supervisors hardly appears to result from using EPAs.
An EPA-based curriculum does stimulate PIF in the complex context of working and learning by supporting participation in the workplace and by encouraging feedback-seeking behavior. Striking the right balance between participation, feedback-seeking behavior and choosing learning activities is essential.
This study was approved by the ethics committee of the Netherlands Association of Medical Education (NVMO, case number 2019.5.12).
可委托的专业活动（EPAs）在医学教育中被广泛应用，它们可能通过积极鼓励学生参与工作场所，成为激励医学生职业认同形成（PIF）的重要激励因素。本研究的目的是探讨基于 EPA 的课程对本科医学学生 PIF 的影响。
在荷兰奈梅亨拉德堡德大学医学中心的这项研究中，作者通过三次焦点小组访谈（2019 年 11 月）对 21 名医学生进行了访谈，并根据 PIF、实践共同体和 EPA 以及新定义的主题对综合概念进行了主题分析。
四个核心主题对于理解 EPA 对 PIF 的影响至关重要：创造学习机会、管理反馈、在背景下处理监督和建立信心。EPAs 帮助学生创造学习机会和有目的地选择活动，并激发他们寻求反馈的行为。监督的背景和方式对他们的发展有很大的影响，在某些背景下提供了比其他背景更好的学习机会。EPAs 帮助他们建立信任和自信，但来自监督者的信任似乎几乎不会因为使用 EPA 而产生。
基于 EPA 的课程通过支持学生参与工作场所和鼓励寻求反馈的行为，在工作和学习的复杂环境中确实激发了 PIF。在参与、寻求反馈行为和选择学习活动之间取得适当的平衡至关重要。
这项研究得到了荷兰医学教育协会（NVMO）伦理委员会的批准（注册号 2019.5.12）。
