可信賴專業活動的疑惑與理解

Entrustable Professional Activities -- Doubts and Understanding

陳祖裕(Cho-Yu Chan)

《The Changhua Journal of Medicine》 15卷2期 (2017/06) Pp. 104-113

https://doi.org/10.6501/CJM.1502.007

摘要

因應生物醫學的快速發展及日益複雜的醫療照護所需，醫學教育必須不斷創新以提升學習成效。近年來醫學教育界對教育成果的重視，以能力導向的訓練(competence-based training, CBT) 儼然成為臨床醫學教育的主流。如何評估教育成果及學習者的能力，也成為醫學教育成敗的關鍵。然而，負責臨床醫學的教師，及教學訓練計畫的負責人，多數是臨床醫療從業人員所兼，對於一些因CBT 的推動應運而生的名詞，如能力 (competence)、里程碑 (milestones) 及可信賴專業活動 (entrustable professional activities, EPAs) 等均不易有具體的認知，甚至引起混淆。在我國，醫學教育者對EPAs 尤其陌生，甚至有所疑慮。本文特針對EPAs 幾個常引起疑惑的議題，包括entrustable 的意涵、EPAs 與能力和里程碑的關係、EPAs 如何使用、EPAs 的監督水平、美國醫學院學會 (Association of American Medical Colleges，AAMC) 的八大核心能力、EPA 為指引的課程設計等逐一說明。

關鍵字

能力導向訓練 ； 核心能力 ； 可信賴專業活動 ； 里程碑

並列摘要

As biomedical science's rapid development and the growing need of medical care, medical education has to be changed continually to enhance learning efficiency. During recent years, competence-based training (CBT) has become the mainstream in education of clinical medicine. The evaluation of educational outcome and learners' competencies have also become the critical topics in medical education. However, clinical teachers, including those responsive for curriculum design, are clinical professionals, most of them are not familiar with the terms derived from CBT, such as competence, milestones and entrustable professional activities (EPAs). In our country, medical educators are especially unfamiliar with EPAs, some educators even have doubts on it. This article aims to explain several issues on EPAs, including the implication of entrustable, the relationship among EPAs, competence and milestones, how to use EPAs, the supervision levels of EPAs, the eight core competencies of Association of American Medical Colleges (AAMC), and finally, EPA-guided curriculum development.

並列關鍵字

competence-based training ； core competencies ； entrustable professional activities ； milestones