置信职业行为在超声住院医师培训中的应用探索  

Application of Entrustable Professional Activities for Ultrasound Residents

作　　者：段新 杜国庆[1] 沈文茜 吴言[1] 陈双[1] 郭子鸿 苏雁欣[1] 田家玮[1] DUAN Xin;DU Guoqing;SHEN Wenqian;WU Yan;CHEN Shuang;GUO Zihong;SU Yanxin;TIAN Jiawei(Department of Ultrasound,The Second Affiliated Hospital of Harbin Medical University,Harbin Heilongjiang 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,黑龙江哈尔滨150086

出　　处：《中国继续医学教育》2021年第27期68-73,共6页China Continuing Medical Education

摘　　要：目的探讨基于置信职业行为(EPAs)的教学新方法在超声住院医师培训中的应用价值。方法哈尔滨医科大学附属第二医院超声医学科根据EPAs的构建方法初步设计"甲状腺结节TI-RADS分级评估与指导治疗"的EPA,自主研发EPA评估表(I~V级),评级达到IV级以上为合格。选取于哈医大二院接受EPAs教学方法的2017~2018级超声住培医师(试验组)120名和接受传统教学方法的2014~2016级超声住培医师(对照组)118名作为研究对象。住培结束时,对两组住院医师的理论知识与实践技能分别进行笔试和上机考核。此外,试验组住培医师在规培期间进行4次EPA评估,并参与教学效果评价的问卷调查。结果(1)试验组出科考核成绩优于对照组[(88.38±6.6)分对(83.02±7.69)分,差异有统计学意义(P<0.01)]。(2)试验组内部EPA评估:4次评估合格率分别为0%、25%、45%和75%。(3)问卷调查:80%的住培医师认为EPAs教学方法效果理想;15%的住培医师认为效果一般;5%的住培医师认为效果不理想。结论接受EPAs教学方法的住院医师考核成绩明显提高,并表现出临床胜任力的逐步提升。EPAs的提出为超声住培提供了全新的视角和方法,有效地促进了超声科住院医师多种临床胜任力的提升。Objective To explore the application value of the new teaching method based on entrustable professional activities(EPAs)in the resident training of ultrasound.Methods The Ultrasonic Department of the Second Affiliated Hospital of Harbin Medical University preliminarily designed the EPA of“Evaluation of TI-RADS grading of thyroid nodules and guiding treatment”according to the construction method of EPAs,then autonomous developed the evaluation table of the EPA(Levels I~V).A rating of IV or above is considered qualified.120 ultrasound residents receiving EPAs teaching method from 2017 to 2018 were selected as the experimental group and 118 ultrasound residents receiving traditional teaching methods from 2014 to 2016 were selected as the control group,all of whom came from the Second Hospital of Harbin Medical University.At the end of the resident training,the theoretical knowledge and practical skills of the two groups were examined by written test and machine operation respectively.In addition,the residents in the experimental group were evaluated four times of the EPA during the training period and participate in the questionnaire survey of teaching effect evaluation.Results(1)Compared with the control group,residents in the experimental group had better performance in the given test[(88.38±6.6)vs.(83.02±7.69),the difference was statistically significant(P<0.01)].(2)The qualified rates of four times evaluations of the EPA within the experimental group were 0%,25%,45%and 75%,respectively.(3)In the survey of teaching satisfaction,80%of the residents believed that the effect of EPAs teaching method was ideal,15%was average,and 5%were not satisfied.Conclusion The results showed the written test and machine operation grades of the experimental group improved obviously,and has progressively improved of clinical competence.The proposal of the concept of EPAs provides a new perspective and method for the resident training of ultrasound,which can effectively promote the improvement of various clinical competencies i

关 键 词：超声医学 置信职业行为 住院医师培训 胜任力 教学改革 临床教学 

分 类 号：G642[文化科学—高等教育学]