Developing a Framework of Entrustable Professional Activities for Residency Training in Hematology.

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Advances in Medical Education and Practice Pub Date : 2025-09-10 eCollection Date: 2025-01-01 DOI:10.2147/AMEP.S541605
Hong Tian, Lan Xu, Jing Xi, Jie Yin, Haiping Dai, Ying Wang, Jia Chen, Chunrui Li, Yu Zhu, Huafeng Wang, Mo Zhou, Yuan Long, Xuewen Song, Li Yang, Jiajun Qi, Jinyi Zhou, Shengli Xue
{"title":"Developing a Framework of Entrustable Professional Activities for Residency Training in Hematology.","authors":"Hong Tian, Lan Xu, Jing Xi, Jie Yin, Haiping Dai, Ying Wang, Jia Chen, Chunrui Li, Yu Zhu, Huafeng Wang, Mo Zhou, Yuan Long, Xuewen Song, Li Yang, Jiajun Qi, Jinyi Zhou, Shengli Xue","doi":"10.2147/AMEP.S541605","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Entrustable professional activities (EPAs), essential for competent and safe clinical practice, serve as milestones to assess trainees' readiness for independent patient care. This study aimed to develop a context-specific EPA framework for hematology residency training in China.</p><p><strong>Methods: </strong>We employed a modified Delphi method involving 35 experts from 8 academic hospitals to establish China's inaugural hematology-specific EPA framework. The development process comprised three key components: (1) a systematic literature review integrating international EPA models with China's the Standardized Training System for Residents (STSR) requirements; (2) structural validation through the EQual rubric (cut-off: 4.07); and (3) a two-round Delphi consultations evaluating importance, observability, evaluability, repeatability, feasibility and entrustment-supervision levels. Expert engagement metrics and inter-rater agreement evaluated consensus quality.</p><p><strong>Results: </strong>The preliminary 14-item framework was ultimately refined to 12 EPAs following the exclusion of \"Public Health Emergency Response\" (EPA 14; mean score=3.23) and \"Imparting Bad News\" (EPA 13; 57.1% experts advocated removing). Key revisions involved expanding the hematopoietic stem cell transplantation (HSCT) competency domain to include donor selection (EPA 7) and the provisional addition then subsequent removal of \"Cellular Immunotherapy Complications Management\" due to insufficient standardization of assessment criteria. The final EPAs achieved unanimous EQual compliance (≥4.07) and strong Delphi consensus (Kendall's W: Round 1 = 0.271, Round 2 = 0.529, p<0.001). Clinical entrustment-supervision levels were systematically stratified by training phase and expected competency at graduation.</p><p><strong>Conclusion: </strong>This study has established China's first hematology-specific EPA framework by addressing gaps in global EPA models through integration of integrating local clinical demands (high patient volume, resource constraints) and multidisciplinary coordination. The framework provides a validated tool for competency-based assessment, with future steps focusing on digital implementation and nationwide validation.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"1651-1663"},"PeriodicalIF":1.7000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433655/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Medical Education and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/AMEP.S541605","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Entrustable professional activities (EPAs), essential for competent and safe clinical practice, serve as milestones to assess trainees' readiness for independent patient care. This study aimed to develop a context-specific EPA framework for hematology residency training in China.

Methods: We employed a modified Delphi method involving 35 experts from 8 academic hospitals to establish China's inaugural hematology-specific EPA framework. The development process comprised three key components: (1) a systematic literature review integrating international EPA models with China's the Standardized Training System for Residents (STSR) requirements; (2) structural validation through the EQual rubric (cut-off: 4.07); and (3) a two-round Delphi consultations evaluating importance, observability, evaluability, repeatability, feasibility and entrustment-supervision levels. Expert engagement metrics and inter-rater agreement evaluated consensus quality.

Results: The preliminary 14-item framework was ultimately refined to 12 EPAs following the exclusion of "Public Health Emergency Response" (EPA 14; mean score=3.23) and "Imparting Bad News" (EPA 13; 57.1% experts advocated removing). Key revisions involved expanding the hematopoietic stem cell transplantation (HSCT) competency domain to include donor selection (EPA 7) and the provisional addition then subsequent removal of "Cellular Immunotherapy Complications Management" due to insufficient standardization of assessment criteria. The final EPAs achieved unanimous EQual compliance (≥4.07) and strong Delphi consensus (Kendall's W: Round 1 = 0.271, Round 2 = 0.529, p<0.001). Clinical entrustment-supervision levels were systematically stratified by training phase and expected competency at graduation.

Conclusion: This study has established China's first hematology-specific EPA framework by addressing gaps in global EPA models through integration of integrating local clinical demands (high patient volume, resource constraints) and multidisciplinary coordination. The framework provides a validated tool for competency-based assessment, with future steps focusing on digital implementation and nationwide validation.

Abstract Image

为血液学住院医师培训建立可信赖的专业活动框架。
目的:可信赖的专业活动(EPAs)对于合格和安全的临床实践至关重要,可作为评估受训者独立患者护理准备情况的里程碑。本研究旨在为中国血液学住院医师培训制定一个特定环境的EPA框架。方法:采用改进的德尔菲法,包括来自8所专科医院的35名专家,建立中国首个血液学特异性EPA框架。该研究的发展过程包括三个关键部分:(1)将国际环境保护模型与中国居民标准化培训系统(STSR)的要求相结合,进行系统的文献综述;(2)通过EQual准则进行结构验证(截止值:4.07);(3)进行两轮德尔菲咨询,评估重要性、可观察性、可评价性、可重复性、可行性和委托监督水平。专家参与指标和评价者之间的协议评估了共识的质量。结果:在排除了“突发公共卫生事件应对”(EPA 14,平均得分=3.23)和“传递坏消息”(EPA 13, 57.1%的专家主张删除)后,初步的14项EPA框架最终细化为12项EPA。关键的修订包括扩大造血干细胞移植(HSCT)的能力范围,包括供体选择(EPA 7),以及由于评估标准不够标准化而临时增加并随后删除“细胞免疫治疗并发症管理”。最终的EPA达到了一致的EQual合规(≥4.07)和强德尔菲共识(Kendall’s W:第1轮= 0.271,第2轮= 0.529)。结论:本研究通过整合本地临床需求(高患者量、资源限制)和多学科协调,解决了全球EPA模型的差距,建立了中国首个血液学特异性EPA框架。该框架为基于能力的评估提供了一个经过验证的工具,未来的步骤将侧重于数字化实施和全国范围内的验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Advances in Medical Education and Practice
Advances in Medical Education and Practice EDUCATION, SCIENTIFIC DISCIPLINES-
CiteScore
3.10
自引率
10.00%
发文量
189
审稿时长
16 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信