Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI.
School of Medicine and Public Health, University of Wisconsin, Madison, WI.
Fam Med. 2024 Sep;56(8):501-504. doi: 10.22454/FamMed.2024.818912. Epub 2024 Jul 1.
Recognition of the need for medical education to train physicians who are skilled at supporting population health and work beyond traditional health care settings is growing. Entrustable professional activities (EPAs) for medical students typically have centered around activities taking place in the clinical workplace; however, EPAs that involve working with community members in community contexts have not been clearly established.
We used a three-stage online modified-Delphi method to identify community-based EPAs for University of Wisconsin School of Medicine and Public Health medical students. We recruited key stakeholders to participate and asked them, based on their experience, to generate a list of community-based tasks that they believed graduates should be trusted to perform. Subsequently, using a five-point anchored Likert scale (1=strongly disagree to 5=strongly agree), we asked participants to rate their level of agreement with each identified task becoming an EPA. An a priori definition of consensus was established.
Twenty-two tasks reached consensus as potential community-based EPAs. The tasks with the highest mean ratings were "addressing trust issues with the medical community amongst the local population" (mean=4.71), "meeting with community members around a health topic" (mean=4.64), "identifying opportunities for disease prevention" (mean=4.64), and "identifying policies that impact community outcomes" (mean=4.57).
The identified community-based tasks can support the augmentation of existing community-based curriculum and help identify areas for novel curriculum and assessment development. Lessons learned from this local effort could be helpful to other programs seeking to establish and refine community-based curricula.
越来越多的人认识到，医学教育需要培养擅长支持人群健康并超越传统医疗保健环境工作的医生。医学生的可信赖专业活动（EPAs）通常集中在临床工作场所进行的活动上；然而，涉及与社区成员在社区环境中合作的 EPAs 尚未明确确立。
我们使用三阶段在线改良 Delphi 方法确定威斯康星大学医学院和公共卫生学院医学生的基于社区的 EPAs。我们招募了关键利益相关者参与，并根据他们的经验要求他们列出一系列他们认为毕业生应该被信任执行的基于社区的任务。随后，使用五点 anchored Likert 量表（1=强烈不同意至 5=强烈同意），我们要求参与者对每个确定的 EPA 任务表示同意程度进行评分。事先定义了共识标准。
有 22 项任务达成共识，成为潜在的基于社区的 EPA。评分最高的任务是“解决当地居民对医疗界的信任问题”（平均 4.71）、“就健康主题与社区成员会面”（平均 4.64）、“识别疾病预防机会”（平均 4.64）和“确定影响社区结果的政策”（平均 4.57）。
确定的基于社区的任务可以支持增强现有的基于社区的课程，并有助于确定新的课程和评估发展领域。从这一本地努力中吸取的经验教训可能对其他寻求建立和完善基于社区的课程的计划有所帮助。
