Andreou Vasiliki, Peters Sanne, Eggermont Jan, Schoenmakers Birgitte
Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium.
School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
J Med Educ Curric Dev. 2024 Sep 24;11:23821205241275810. doi: 10.1177/23821205241275810. eCollection 2024 Jan-Dec.
Competency-based medical education (CBME) has transformed postgraduate medical training, prioritizing competency acquisition over traditional time-based curricula. Integral to CBME are Entrustable Professional Activities (EPAs), that aim to provide high-quality feedback for trainee development. Despite its importance, the quality of feedback within EPAs remains underexplored.
We employed a cross-sectional study to explore feedback quality within EPAs, and to examine factors influencing length of written comments and their relationship to quality. We collected and analyzed 1163 written feedback comments using the Quality of Assessment for Learning (QuAL) score. The QuAL aims to evaluate written feedback from low-stakes workplace assessments, based on 3 quality criteria (evidence, suggestion, connection). Afterwards, we performed correlation and regression analyses to examine factors influencing feedback length and quality.
EPAs facilitated high-quality written feedback, with a significant proportion of comments meeting quality criteria. Task-oriented and actionable feedback was prevalent, enhancing value of low-stakes workplace assessments. From the statistical analyses, the type of assessment tool significantly influenced feedback length and quality, implicating that direct and video observations can yield superior feedback in comparison to case-based discussions. However, no correlation between entrustment scores and feedback quality was found, suggesting potential discrepancies between the feedback and the score on the entrustability scale.
This study indicates the role of the EPAs to foster high-quality feedback within CBME. It also highlights the multifaceted feedback dynamics, suggesting the influence of factors such as feedback length and assessment tool on feedback quality. Future research should further explore contextual factors for enhancing medical education practices.
基于胜任力的医学教育（CBME）已经改变了研究生医学培训，将能力获得置于传统的基于时间的课程之上。可托付专业活动（EPA）是CBME的核心，旨在为学员发展提供高质量反馈。尽管其很重要，但EPA内反馈的质量仍未得到充分探索。
我们采用横断面研究来探索EPA内的反馈质量，并检查影响书面评论长度的因素及其与质量的关系。我们使用学习评估质量（QuAL）评分收集并分析了1163条书面反馈评论。QuAL旨在基于3个质量标准（证据、建议、联系）评估来自低风险工作场所评估的书面反馈。之后，我们进行了相关性和回归分析，以检查影响反馈长度和质量的因素。
EPA促进了高质量的书面反馈，很大一部分评论符合质量标准。以任务为导向且可采取行动的反馈很普遍，提高了低风险工作场所评估的价值。从统计分析来看，评估工具的类型显著影响反馈长度和质量，这意味着与基于案例的讨论相比，直接观察和视频观察可以产生更好的反馈。然而，未发现托付分数与反馈质量之间存在相关性，这表明反馈与托付量表上的分数之间可能存在差异。
本研究表明了EPA在CBME中促进高质量反馈的作用。它还突出了多方面的反馈动态，表明反馈长度和评估工具等因素对反馈质量的影响。未来的研究应进一步探索增强医学教育实践的背景因素。
