Gehrke-Beck Sabine, Holzhausen Ylva
Institute of General Practice, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
Dieter Scheffner Center for Medical Education and Educational Research, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
BMC Med Educ. 2025 Sep 12;25(1):1253. doi: 10.1186/s12909-025-07870-9.
The concept of Entrustable Professional Activities (EPAs) is being increasingly adopted for teaching tasks. However, it is debated how entrustment of teaching EPAs compares to entrustment of clinical EPAs. This study investigates the factors influencing the decision to entrust trainees with the supervision of medical students in general practice.
Semi-structured interviews were conducted with nine general practitioners (GPs) and nine GP trainees. The interviews were transcribed and analyzed using the six steps of Braun and Clarke's thematic analysis.
Entrustment of student supervision to GP trainees was influenced by factors related to the GP trainee, the GP, the relationship between the GP trainee and the GP, the teaching task, and the context. Trainee factors included enjoyment of teaching, familiarity with the practice environment, teaching skills and knowledge. Teaching skills were often considered as personality traits rather than learnable skills. Contextual factors included workload and availability of protected teaching time, and availability of students, teachers, and patients. Risks are seen in overburdening trainees and passing on incorrect knowledge.
The entrustment of teaching EPAs is influenced by comparable factors as the entrustment of clinical EPAs. Didactic training could support trainees. Explicit entrustment and assessment by direct supervision are not established in the practice context but could help to minimize the risks associated with trainee teaching.
可托付专业活动（EPAs）的概念正越来越多地应用于教学任务中。然而，教学EPAs的托付与临床EPAs的托付相比情况如何，仍存在争议。本研究调查了影响在全科医疗中委托实习医生监督医学生这一决策的因素。
对9名全科医生（GP）和9名GP实习医生进行了半结构化访谈。访谈内容经转录后，采用布劳恩和克拉克主题分析的六个步骤进行分析。
将学生监督工作托付给GP实习医生受到与GP实习医生、GP、GP实习医生与GP之间的关系、教学任务以及环境相关的因素影响。实习医生因素包括对教学的喜爱、对实习环境的熟悉程度、教学技能和知识。教学技能通常被视为个性特征而非可习得的技能。环境因素包括工作量、有保护的教学时间的可用性，以及学生、教师和患者的可用性。存在使实习医生负担过重和传递错误知识的风险。
教学EPAs的托付受到与临床EPAs的托付类似的因素影响。讲授式培训可为实习医生提供支持。在实践环境中尚未确立通过直接监督进行明确的托付和评估，但这有助于将与实习医生教学相关的风险降至最低。
