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Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

机译：在本科医学教育临床教育中使用委托专业活动：范围审查

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Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.
机译：委托的专业活动（EPAS）越来越多地用于本科医学教育（UME）。我们进行了一个范围的审查，以总结在UME临床旋转中使用EPA的证据。我们搜索了多个数据库，以基于Prisma关于报告定性和定量研究的Prisma指南，以及UME临床旋转中的EPAS的概念和课程开发报告。通过搜索多个数据库，我们确定了3309条记录。在删除重复后，筛查了1858个报告。共有36个制品用于数据提取。其中，47％关于牧师的EPA和基于EPA和EPA的课程开发报告，50％关于实施战略报告，53％关于职员的评估方法和工具报告。在职员的背景下开发EPA的有效框架是不一致的。若干专业报告了基于EPA的职员课程的可行的实施策略，但是这些需要额外的师资时间和资源。有限地接触临床活动被确定为相关学习经历的障碍。教育工作者使用全国定义的或特定特定的EPA和一系列贫困和监督尺度。我们只发现了一项研究，用于对EPA评估进行实证研究方法。一篇文章报告了本隶属于裁军毕业生教育的基于总结委托决定。有关于EPAS如何有效地引入UME的临床训练的新的证据。特定于特殊的嵌套EPA，委托监督尺度可能有用，更好地利用其形成性评估潜力。

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