Pinilla Severin, Bauer Werner, Breckwoldt Jan, Burkhart Christoph S, Hennel Eva K, Marty Adrian P, von Wartburg Urs, Brodmann Maeder Monika, Huwendiek Sören
University of Bern, Institute for Medical Education, Department for Assessment and Evaluation, Bern, Switzerland.
University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland.
GMS J Med Educ. 2024 Nov 15;41(5):Doc60. doi: 10.3205/zma001715. eCollection 2024.
Graduate medical education is being reformed in many countries, with a focus on the principles of competency-based medical education (CBME). A main novel aspect in this context is the implementation of entrustable professional activities (EPAs). The introduction of EPAs aims to better align training curricula with clinical practice, provide individualized supervision, and enhance the quality of feedback.
This project report presents the development of a national strategy and the initial results of implementing entrustable professional activities in the Swiss context.
Affiliated with the Swiss Institute of Medical Education (SIME), an EPA-Commission was established with the mandate to develop a strategy and provide guidance to medical specialty societies. To date, 28 out of 45 specialty societies have sought advice from the EPA-Commission and have begun developing EPAs. Concurrently, the Commission has expanded the national faculty development courses, adapted the content, started offering multilingual courses, and has published a series of articles on CBME and EPAs. Selected pilot hospitals are now planning to implement EPA-based graduate medical education curricula. Additionally, the introduction of a nationwide electronic solution (app) for assessing EPAs is planned.
The introduction of EPAs in graduate medical education is a multilayered project. In addition to medical education aspects, various social, organizational, and professional-political factors are crucial for the transformation processes. In the Swiss context, such a reform has been successfully initiated. Continuous evaluations of the ongoing projects will provide further insights for competency-based graduate medical education reforms.
许多国家正在对毕业后医学教育进行改革，重点是基于胜任力的医学教育（CBME）原则。在此背景下，一个主要的新方面是可托付专业活动（EPA）的实施。引入EPA旨在使培训课程更好地与临床实践相结合，提供个性化监督，并提高反馈质量。
本项目报告介绍了一项国家战略的制定以及在瑞士实施可托付专业活动的初步成果。
与瑞士医学教育研究所（SIME）相关联，成立了一个EPA委员会，其任务是制定战略并为医学专业协会提供指导。迄今为止，45个专业协会中有28个已向EPA委员会寻求建议，并已开始制定EPA。与此同时，该委员会扩大了国家师资发展课程，调整了内容，开始提供多语言课程，并发表了一系列关于CBME和EPA的文章。选定的试点医院目前正在计划实施基于EPA的毕业后医学教育课程。此外，计划引入一种用于评估EPA的全国性电子解决方案（应用程序）。
在毕业后医学教育中引入EPA是一个多层次的项目。除医学教育方面外，各种社会、组织和专业政治因素对转型过程至关重要。在瑞士的背景下，这样的改革已成功启动。对正在进行的项目进行持续评估将为基于胜任力的毕业后医学教育改革提供进一步的见解。
