置信职业行为在老年医学住院医师老年综合评估培训中的应用  

The application of entrustable professional activities in training of comprehensive geriatric assessment for aging medicine residents

作　　者：徐哲荣[1] 蒋婧瑾[1] 陈路芳 徐珂莹 XU Zherong;JIANG Jingjin;CHEN Lufang;XU Keying(Department of Aging Medicine,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院老年医学科,杭州310003

出　　处：《浙江医学教育》2024年第2期95-99,共5页Zhejiang Medical Education

摘　　要：人口老龄化是我国社会当前和今后相当长一段时间的显著特征,如何应对老年人口增长给医疗领域带来的压力、如何实现健康老龄化,是当前面临的重大任务。老年综合评估以老年患者为中心,包含躯体疾病、心理健康、生活环境、社会支持等全方位内容,是实现个体化诊疗、促进健康老龄化的有效方法。鉴于老年综合评估过程复杂,传统的培训方法难以让学习者迅速掌握相关内容,也无法用量化指标体现学习者的掌握程度,不利于指导教师对他们进行有效评价。浙江大学医学院附属第一医院老年医学科将置信职业行为应用于老年医学住院医师老年综合评估培训中,将老年综合评估过程中所有关键环节提取出来,并设定分级标准,为学习者提供了明确的学习框架,描述了不同阶段应当达到的置信等级,这有助于弥合教学理论和临床实践之间的差距,在教学实践中亦初步展现了良好的效果。在今后的工作过程中,应该完善置信职业行为的评价方法及其在老年综合评估培训中的应用,同时探索其在老年医学住院医师规范化培训等其他教学方面的价值,促进学习者和教学者的共同进步,为健康老龄化发挥积极的作用。Population aging is a remarkable feature of our society at present and in the future for a long time.How to deal with the pressure brought by the growth of the elderly population on the medical field and how to realize the healthy aging is a major task.Comprehensive geriatric assessment(CGA)is patient-centered,including physical diseases,mental health,living environment,social support and other contents,which is an effective way to realize individualized diagnosis and treatment and promote healthy aging.In view of the complex process of CGA,the current training methods are difficult for new learners to quickly master it,and the trainers are also difficult to use quantitative indicators to reflect the degree of mastery of learners and give effective evaluation to them.Department of Aging Medicine,The First Affiliated Hospital,Zhejiang University School of Medicine adopted the entrustable professional activities(EPA)in teaching of comprehensive geriatric assessment for aging medicine training.EPA extracted all the key links in the CGA process and set grading standards,provided a clear learning framework for learners and described the belief levels that should be achieved in different stages,which helped bridge the gap between teaching theory and clinical practice,and initially showed a good effect in teaching practice.In the future work,the evaluation method of EPA and the application of EPA should be improved in CGA training,and explore its value in standardized training of aging medicine resident and other teaching aspects,so as to promote the common progress of learners and teachers,and play a positive role in healthy aging.

关 键 词：老年医学 老年综合评估 置信职业行为 住院医师 

分 类 号：R-05[医药卫生]