可信賴專業活動於兒癌心理照護之經驗分享

Abstract

本案例報告為試用可信賴專業活動(Entrustable Professional Activities, EPAs)於兒童癌症心理照護臨床教學的經驗分享。對象為1位臨床心理PGY(Post-graduate year)學員在1位臨床教師督導下，於某醫學中心癌童病房執行心理照護，從2020年8月至11月探視16人，計34人次；每次照會，學員及教師分別填寫EPAs即時評量，內涵可對應ACGME(Accreditation Council for Graduate Medical Education)六大核心能力，針對當次照會做即時信賴等級的評量及需加強項目之量化與質性雙向回饋討論。EPAs量化結果呈現教師評核學員專業任務表現之進步，質性討論反映出教學效能增進，可作為總評及勝任能力授權依據。EPAs的推廣需要更多臨床教師的修正討論並試用，以確認其信、效度，優化臨床心理教學效能及照護品質。  This study describes the experience of a postgraduate clinical psychology student working with children with cancer and their families as part of a training program that incorporated entrustable professional activities (EPAs) into its framework. The student was supervised by a clinical supervisor. The training program involved providing psychological care for 16 children with cancer in the pediatric ward of a medical center from August to November 2020. The student and supervisor both assessed EPAs corresponding to the six general competencies defined by the Accreditation Council for Graduate Medical Education and used quantitative and qualitative two-way feedback to explore the relationship between EPAs and the core competencies. The quantitative results revealed progressive improvement over the different training phases, and qualitative feedback indicated increased comprehension by and self-modification from the student. This information can be used to assess the student’s performance and authorization for managing EPAs. Programs that adopt EPAs would benefit from increased participation by clinical supervisors, who are best positioned to discuss, revise, and support the implementation of EPAs to ensure their reliability and validity, thereby optimizing educational effectiveness and the quality of health-care services.