Yun Zhang, Jing Liu, Junfei Chen, Wenjing Zhang, Jinxiang Wu, Tong Yue, Aijun Zhang
Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China.
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Pediatr. 2022 Jul 4;10:919481. doi: 10.3389/fped.2022.919481. eCollection 2022.
Entrustable professional activities (EPAs) were first introduced by Olle ten Cate in 2005. Since then, hundreds of applications in medical research have been reported worldwide. However, few studies discuss the use of EPAs for residency training in pediatric intensive care medicine. We conducted a pilot study of EPA for pediatric intensive care medicine to evaluate the use of EPAs in this subspecialty.
A cross-sectional study was implemented in pediatric intensive care medicine standardized residency training at the Qilu Hospital of Shandong University. An electronic survey assessing EPA performance using eight scales composed of 15 categories were distributed among residents and directors.
A total of 217 director-assessment and 44 residents' self-assessment questionnaires were collected, both demonstrating a rising trend in scores across postgraduate years. There were significant differences in PGY1-vs.-PGY2 and PGY1-vs.-PGY3 director-assessment scores, while there were no differences in PGY2-vs.-PGY3 scores. PGY had a significant effect on the score of each EPA, while position significantly affected the scores of all EPAs except for EPA1 (Admit a patient) and EPA2 (Select and interpret auxiliary examinations). Gender only significantly affected the scores of EPA6 (Report a case), EPA12 (Perform health education), and EPA13 (Inform bad news).
This study indicates that EPA assessments have a certain discriminating capability among different PGYs in Chinese standardized residency training in pediatric intensive care medicine. Postgraduate year, gender, and resident position affected EPA scores to a certain extent. Given the inconsistency between resident-assessed and director-assessed scores, an improved feedback program is needed in the future.
可托付专业活动（EPA）于2005年由奥勒·滕·凯特首次提出。从那时起，全球范围内已报道了数百项在医学研究中的应用。然而，很少有研究讨论EPA在儿科重症医学住院医师培训中的应用。我们开展了一项针对儿科重症医学EPA的试点研究，以评估EPA在该亚专业中的应用。
在山东大学齐鲁医院的儿科重症医学标准化住院医师培训中开展了一项横断面研究。向住院医师和主任发放了一份电子调查问卷，该问卷使用由15个类别组成的8个量表来评估EPA表现。
共收集到217份主任评估问卷和44份住院医师自我评估问卷，两者均显示出研究生各年级的得分呈上升趋势。PGY1与PGY2以及PGY1与PGY3的主任评估得分存在显著差异，而PGY2与PGY3的得分无差异。PGY对每个EPA的得分有显著影响，而职位仅对除EPA1（收治患者）和EPA2（选择并解读辅助检查）之外的所有EPA得分有显著影响。性别仅对EPA6（报告病例）、EPA12（开展健康教育）和EPA13（告知坏消息）的得分有显著影响。
本研究表明，在中国儿科重症医学标准化住院医师培训中，EPA评估在不同PGY之间具有一定的区分能力。研究生年级、性别和住院医师职位在一定程度上影响EPA得分。鉴于住院医师评估得分与主任评估得分之间存在不一致，未来需要改进反馈方案。
