Zhang Wenjing, Hao Yiping, Zhang Teng, Jiao Xinlin, Mao Zhonghao, Zhang Yuankai, Zhao Dongxiu, Cui Baoxia
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, 250012, China.
Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, 250012, China.
BMC Med Educ. 2025 May 28;25(1):789. doi: 10.1186/s12909-025-06973-7.
Entrustable professional activity (EPA) presents trainees' tasks or responsibilities which are entrusted to the unsupervised execution once they have attained sufficient specific competence. EPAs evaluation emphasize the integrity of medical behavior, directly reflecting the clinical ability of trainees and reflect the trust of trainers. Compared with other evalution method, EPAs evaluation is more close to clinical practice and can better reflect clinical competence. Our study conducted a multi-center study in Qilu Hospital of Shandong University to evaluate EPAs among residents. This study was to evaluate EPAs of residents and identify problems in the residency training in Shandong Province, so as to put forward constructive suggestions in futrue.
This is a cross-sectional study. An assessment survey comprised of 15 EPAs was invented and carried out in Department of Obstetrics and Gynecology, Qilu hospital of Shandong Province. Each resident conducted self-assessment and director-assessment through by internet questionnaire of Wenjuanxing.
In our study, 132 residents and 45 directors were totally enrolled. Both self- and director- assessment had an increased scores trend year by year in each EPAs. However, for PGY1 and PGY2 residents, self-assessment and director-assessment results were relatively consistent. Compared with director-assessment, significant difference was found in self-assessment on admit a patient, select and interpret auxiliary examinations, compose medical documents, perform basic operation and perform health education. Among the four different position of residents (social training residents, entrusted training residents, professional master and permanent staff), permanent staff has the highest EPA scores in this EPAs-evaluation study. In this study, we found significant difference between self-assessment and director-assessment in PGY2 and PGY3 (p < 0.05).
EPAs are practically useful in assessment of OB &GYN residents. EPA4, EPA7, EPA1 and EPA15 need to be improved in future training. Individualized feedbacks should be provided based on the difference between self-assessment and director- assessment.
可托付专业活动（EPA）呈现给受训者的任务或职责，一旦他们获得足够的特定能力，便被托付给他们独立执行。EPA评估强调医疗行为的完整性，直接反映受训者的临床能力，并体现培训者的信任。与其他评估方法相比，EPA评估更贴近临床实践，能更好地反映临床能力。我们的研究在山东大学齐鲁医院开展了一项多中心研究，以评估住院医师的EPA。本研究旨在评估住院医师的EPA，识别山东省住院医师培训中存在的问题，以便在未来提出建设性建议。
这是一项横断面研究。在山东省齐鲁医院妇产科设计并开展了一项由15项EPA组成的评估调查。每位住院医师通过问卷星网络问卷进行自我评估和主任评估。
在我们的研究中，共纳入132名住院医师和45名主任。在各项EPA中，自我评估和主任评估的得分均呈逐年上升趋势。然而，对于第一年住院医师（PGY1）和第二年住院医师（PGY2），自我评估和主任评估结果相对一致。与主任评估相比，在收治患者、选择和解读辅助检查、撰写医疗文件、进行基本操作和开展健康教育的自我评估中发现显著差异。在住院医师的四个不同岗位（社会培训住院医师、委培住院医师、专业硕士和在编人员）中，在编人员在本次EPA评估研究中的EPA得分最高。在本研究中，我们发现PGY2和PGY3的自我评估和主任评估之间存在显著差异（p < 0.05）。
EPA在妇产科住院医师评估中切实有用。在未来培训中，EPA4、EPA7、EPA1和EPA15需要改进。应根据自我评估和主任评估之间的差异提供个性化反馈。
