在培训第一年开始和结束时评估内部对可信任专业活动的信心:一项纵向观察研究
Yana Zemkova1, Jennifer Strouse2, Jane Rowat3
1at the time of the study was a PGY-7, Pulmonary Critical Care Fellow, and is now Clinical Assistant Professor, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Journal of graduate medical education
|October 17, 2025
概括
在整个居留期间,内部对核心可委托专业活动 (EPA) 的信心显著提高. 然而,关于程序和识别系统故障的信任差距仍然存在.
科学领域:
- 医学教育 医学教育
- 研究生医学培训研究生医学培训
- 内部医疗住院内科医生
背景情况:
- 美国医学院协会为实习生建立了13项核心可委托专业活动 (EPA).
- 有关医学毕业生准备能力和实习生对执行EPA的自信存在担忧.
- 评估实习生信心对于研究生监督和专业身份发展至关重要.
研究的目的:
- 评估从实习开始到实习结束时,实习生对执行EPA的自我报告信心的变化.
- 确定需要进一步关注的信任级别的特定EPA.
主要方法:
- 在学术内科住院计划 (2019-2024) 中进行了一项观察性研究.
- 在实习开始和结束时使用调查来评估实习生的信心.
- 匹配的配对t测试和效果大小指标被用来分析信心的变化.
主要成果:
- 在实习一年中,所有13个EPA的信心都增加了 (平均增加11.95点).
- 最初的高可信度领域包括历史/身体检查,文档和团队合作.
- 仍然存在显著的信任差距,特别是在执行一般程序 (70%缺乏信任) 和识别系统故障 (59%缺乏信任) 方面.
结论:
- 内部对核心EPAs的信心在居住的第一年显著改善.
- 尽管总体上取得了进展,但具体领域如程序技能和系统故障识别需要有针对性的干预.
- 解决这些信任差距对于提高内部准备和患者安全至关重要.
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