David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Department of Medicine Statistics Core, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Med Educ Online. 2024 Dec 31;29(1):2352217. doi: 10.1080/10872981.2024.2352217. Epub 2024 May 17.
As medical schools move to integrate the Core Entrustable Professional Activities for Entering Residency (EPAs) into curricula and address the transition from student to resident, residency preparatory courses have become more prevalent. The authors developed an experiential learning EPA-based capstone course for assessment to determine impact on learner self-assessed ratings of readiness for residency and acquisition of medical knowledge. All fourth-year students from the classes of 2018-2020 completed a required course in the spring for assessment of multiple EPAs, including managing core complaints, performing basic procedures, obtaining informed consent, and providing patient handoffs. Learners selected between three specialty-based parallel tracks - adult medicine, surgery, or pediatrics. Students completed a retrospective pre-post questionnaire to provide self-assessed ratings of residency preparedness and comfort in performing EPAs. Finally, the authors studied the impact of the course on knowledge acquisition by comparing student performance in the adult medicine track on multiple choice pre- and post-tests. Four hundred and eighty-one students were eligible for the study and 452 (94%) completed the questionnaire. For all three tracks, there was a statistically significant change in learner self-assessed ratings of preparedness for residency from pre- to post-course (moderately or very prepared: adult medicine 61.4% to 88.6% [p-value < 0.001]; surgery 56.8% to 81.1% [p-value < 0.001]; pediatrics 32.6% to 83.7% [p-value 0.02]). A similar change was noted in all tracks in learner self-assessed ratings of comfort from pre- to post-course for all studied EPAs. Of the 203 students who participated in the adult medicine track from 2019-2020, 200 (99%) completed both the pre- and post-test knowledge assessments. The mean performance improved from 65.0% to 77.5% (p-value < 0.001). An experiential capstone course for the assessment of EPAs can be effective to improve learner self-assessed ratings of readiness for residency training and acquisition of medical knowledge.
随着医学院将核心可信赖专业活动（EPAs）整合到课程中，并解决从学生到住院医师的过渡问题，预备住院医师课程变得越来越普遍。作者为评估对学习者对住院准备和获取医学知识的自我评估准备程度的影响而开发了一门基于体验式学习的 EPA 顶点课程。2018-2020 年所有四年级学生都在春季完成了一门必修课程，以评估多项 EPA，包括管理核心投诉、执行基本程序、获得知情同意和提供患者交接。学习者可以在成人医学、外科或儿科三个专业平行轨道中进行选择。学生完成了一份回顾性的前后问卷调查，提供对住院准备和执行 EPA 的自我评估舒适度的评价。最后，作者通过比较成人医学轨道学生在多项选择前测和后测中的表现，研究了该课程对知识获取的影响。共有 481 名学生符合研究条件，其中 452 名（94%）完成了问卷。对于所有三个轨道，学习者对从课程前到课程后的住院准备的自我评估评分都有统计学意义上的显著变化（准备程度：成人医学 61.4%到 88.6%[p 值<0.001]；外科 56.8%到 81.1%[p 值<0.001]；儿科 32.6%到 83.7%[p 值 0.02]）。在所有轨道中，学习者对从课程前到课程后对所有研究的 EPA 的自我评估舒适度评分都有类似的变化。在 2019-2020 年参加成人医学轨道的 203 名学生中，有 200 名（99%）完成了前测和后测知识评估。平均表现从 65.0%提高到 77.5%（p 值<0.001）。用于评估 EPA 的体验式顶点课程可以有效提高学习者对住院医师培训准备和医学知识获取的自我评估准备程度。
