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跨学科可委托的专业活动。

Transdisciplinary entrustable professional activities.

机构信息

Isala Academy, Isala Hospitals, Zwolle, The Netherlands.

Health Academy, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Med Teach. 2023 Sep;45(9):1019-1024. doi: 10.1080/0142159X.2023.2170778. Epub 2023 Jan 28.

Abstract

Healthcare has become highly specialized. Specialists, in medicine as well as in nursing, determine much of the high quality of current health care. But healthcare has also become increasingly fragmented, with professionals trained in separate postgraduate silos, with boundaries often difficult to cross. While a century ago, generalists dominated patient care provision, now specialists prevail and risk becoming alienated from each other, losing the ability to adapt to neighboring professional domains. Current health care requires a flexible workforce, ready to serve in multiple contexts, as the COVID-19 crisis has shown.The new concept of transdisciplinary entrustable professional activities, EPAs applicable in more than one specialty, was recently conceived to enhance collaboration and transfer between educational programs in postgraduate nursing in the Netherlands.In this paper, we reflect on our experiences so far, and on practical and conceptual issues concerning transdisciplinary EPAs, such as: who should define, train, assess, and register transdisciplinary EPAs? How can different prior education prepare for similar EPAs? And how do transdisciplinary EPAs affect professional identity?We believe that transdisciplinary EPAs can contribute to creating more flexible curricula and hence to a more coherent, collaborative healthcare workforce, less determined by the boundaries of traditional specialties.

摘要

医疗保健已变得高度专业化。医学和护理领域的专家在很大程度上决定了当前医疗保健的高质量。但医疗保健也变得越来越碎片化,受过专业研究生培训的专业人员分属于不同的领域,界限往往难以跨越。虽然一个世纪前,通才主导着患者护理服务,但现在专家占主导地位,并且有彼此疏远的风险,从而丧失适应相邻专业领域的能力。正如 COVID-19 危机所表明的那样,当前的医疗保健需要一支灵活的劳动力队伍,随时准备在多个领域提供服务。最近提出了跨学科可委托专业活动(EPAs)的新概念,这些活动适用于多个专业,旨在加强荷兰研究生护理教育项目之间的合作和交流。在本文中,我们反思了迄今为止的经验,以及跨学科 EPAs 涉及的实际和概念问题,例如:应该由谁来定义、培训、评估和注册跨学科 EPAs?不同的前期教育如何为类似的 EPAs 做准备?以及跨学科 EPAs 如何影响专业身份?我们相信,跨学科 EPAs 可以有助于创建更灵活的课程,从而为更连贯、更具协作性的医疗保健劳动力做出贡献,减少传统专业界限的影响。

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