Lee Rebecca, Dhami Neil, Gibson William, Hamza Deena M, Oswald Anna E, Moffat Mandy
Department of Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Centre for Medical Education, School of Medicine, University of Dundee, Dundee, UK.
Clin Teach. 2025 Jun;22(3):e70089. doi: 10.1111/tct.70089.
Entrustable professional activity (EPA) observations can be used to develop a holistic picture of trainee competency in professional tasks. Narrative feedback is an essential component of EPAs, but there is a lack of published literature capturing undergraduate student perceptions.
Students who completed Year 3 of the MD programme in 2022-2023 at one institution in Canada were invited to participate in a survey designed to elicit their perceptions of narrative feedback in EPAs. Survey methods included closed-ended questions (analysed descriptively) and open-ended questions (analysed through thematic analysis).
The response rate to the survey was 23%. Over 60% of students reported that narrative comments in EPAs were specific and aligned with EPA scores, and 86% reported that the narrative feedback was individualised at least some of the time. However, 57% reported that they never or rarely received actionable feedback for growth. Students demonstrated mixed feelings as to whether EPAs help support their clinical development. Some noted that they can help students identify gaps and reinforce positives. Others reported preferring verbal feedback to written feedback and that EPAs resulted in an administrative burden. Over 90% of students reported barriers to obtaining EPAs, and almost 90% expressed the need for changes to EPAs. A predominant theme from students was the desire for a reduction in EPA requirements.
Students perceived the narrative feedback to be individualized and specific but reported that the feedback rarely contained feedback for growth. Students identified several barriers to EPA completion and provided recommended changes.
可信赖专业活动（EPA）观察可用于全面了解实习生在专业任务中的能力。叙事性反馈是EPA的重要组成部分，但缺乏已发表的文献来了解本科学生的看法。
邀请了在加拿大一所机构完成2022 - 2023学年医学博士课程三年级的学生参与一项旨在了解他们对EPA中叙事性反馈看法的调查。调查方法包括封闭式问题（进行描述性分析）和开放式问题（通过主题分析）。
调查的回复率为23%。超过60%的学生报告称，EPA中的叙事性评论具体且与EPA分数相符，86%的学生报告称叙事性反馈至少在某些时候是个性化的。然而，57%的学生报告称他们从未或很少收到可用于成长的可操作反馈。学生们对EPA是否有助于支持他们的临床发展看法不一。一些人指出，EPA可以帮助学生发现差距并强化优点。另一些人报告称更喜欢口头反馈而非书面反馈，并且EPA带来了行政负担。超过90%的学生报告了获取EPA存在障碍，近90%的学生表示需要对EPA进行改进。学生们的一个主要主题是希望减少EPA的要求。
学生认为叙事性反馈是个性化且具体的，但报告称反馈很少包含用于成长的内容。学生们确定了完成EPA的几个障碍并提出了建议的改进措施。
