基于重要性的精神科住院医师培训可托付专业活动方法

Importance-based approach to entrustable professional activities for psychiatric residency training.

作者信息

Chen Wen-Yin, Chu Chih-Pang, Huang Tzu-Fu, Chang Hu-Ming, Kuo Feng-Jung, Liu Yu-Ting, Peng Sheng-Hsun, Lee Cheng-Jui, Hung Yan-Jiun, Lin Yueh-Pin, Huang Ming-Chyi, Kuo Chian-Jue

机构信息

Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan.

School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.

出版信息

BMC Med Educ. 2025 Jul 17;25(1):1068. doi: 10.1186/s12909-025-07655-0.

Abstract

BACKGROUND

Entrustable professional activities (EPAs) are essential tools in implementing CBME and integrating milestones into clinical practice. This study aimed to develop a set of EPAs tailored to the psychiatric residency training context with local institutional needs, and to dissect the differences and factor analysis in perceived EPA importance.

METHODS

21 customized EPAs specific to psychiatric residency training at Taipei City Psychiatric Center (TCPC) were developed based on the Taiwanese Society of Psychiatry (TSOP) framework. A two-round Delphi method was used to achieve consensus for the EPAs. The finalized EPAs were evaluated using an online questionnaire, and faculty members and residents rated each activity's importance on a Likert scale of 0-10. Statistical analyses were performed on perceptions differences between teachers and trainees, and to cluster EPAs into meaningful competency clusters.

RESULTS

The finalized TCPC EPA framework included the TSOP's original 17 EPAs and four additional EPAs to address advanced skills in psychotherapy, rehabilitation, legal applications, and innovative technologies. The total response rate was 89.6% for questionnaire assessing importance. Faculty consistently rated EPAs as more important than residents did, particularly clinical documentation, teaching and long-term care planning. Factor analysis revealed two loading factors, referring to internal knowledge and an external communication.

CONCLUSION

The experience of adapting EPAs from global and national standards to fit the characteristics of a local training institution provides a valuable reference for the localization of EPA development. Observed differences in perceptions between trainees and teachers highlight the importance of aligning educational expectations. Enhancing awareness of the underlying dimensions associated with EPAs may help optimize psychiatric training outcomes for both trainees and instructors.

摘要

背景

可托付专业活动(EPA)是实施基于能力的医学教育(CBME)并将里程碑融入临床实践的重要工具。本研究旨在根据当地机构需求,制定一套适合精神科住院医师培训环境的EPA,并剖析EPA重要性认知方面的差异及进行因素分析。

方法

基于台湾精神医学会(TSOP)框架,制定了21项针对台北市立精神病中心(TCPC)精神科住院医师培训的定制EPA。采用两轮德尔菲法就这些EPA达成共识。使用在线问卷对最终确定的EPA进行评估,教员和住院医师以0至10的李克特量表对每项活动的重要性进行评分。对教师和学员之间的认知差异进行统计分析,并将EPA聚类为有意义的能力组群。

结果

最终确定的TCPC EPA框架包括TSOP原有的17项EPA以及另外四项EPA,以涵盖心理治疗、康复、法律应用和创新技术方面的高级技能。评估重要性的问卷总回复率为89.6%。教员对EPA的评分始终高于住院医师,特别是在临床记录、教学和长期护理规划方面。因素分析揭示了两个负荷因子,分别指内部知识和外部沟通。

结论

将EPA从全球和国家标准调整以适应当地培训机构特点的经验,为EPA开发的本地化提供了宝贵参考。学员和教师之间观察到的认知差异凸显了使教育期望保持一致的重要性。提高对与EPA相关潜在维度的认识,可能有助于优化学员和教员的精神科培训成果。

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