Do summative entrustment decisions actually lead to entrustment?

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-10-10 DOI:10.1111/tct.13668

Vigfús Sigurdsson, Olle ten Cate

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引用次数: 0

Abstract

Background

Entrustable professional activities (EPAs) were introduced across Dutch postgraduate programmes between 2017 and 2019. We aimed to understand the extent to which residents actually were granted increased clinical responsibility upon receiving summative entrustment for an EPA, a critical feature of its use.

Methods

A survey study was conducted among all Dutch residents who started dermatology training in 2018 and 2019 and all Dutch dermatology programme directors (PDs). We chose an EPA designed for early entrustment in residency (identification, treatment and care regarding a simple dermatological problem in the ambulatory setting). The survey contained two hypothetical clinical cases that aligned with this EPA. The questions were aimed to determine whether and when residents should request supervision. Similar questions were posed to PDs.

Findings

Twenty four residents (56%) and 19 PDs (79%) completed the survey. The majority of the residents (65%) and PDs (63%) confirmed that competent dermatology residents (level 4) are generally allowed to perform EPA1 unsupervised, particularly when seeing patients from GPs. However, still a substantial proportion of the level 4 residents, working in University Medical Centers (36%) indicated that they had to request supervision in the assessment of these patients. For 2nd opinions, the results were typically the opposite.

Discussion and Conclusion

This study demonstrated that, at least in one specialty and one country, the introduction of EPAs and entrustment decision making procedure generally led to the intended autonomy of the resident.

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总结性委托决策真的会导致委托吗？

背景：2017年至2019年间，荷兰研究生课程引入了可委托专业活动。我们的目的是了解在接受EPA的总结性委托后，居民实际被赋予增加临床责任的程度，这是EPA使用的一个关键特征。方法：在2018年和2019年开始皮肤科培训的所有荷兰居民和所有荷兰皮肤科项目主任（PD）中进行了一项调查研究。我们选择了一个为住院早期委托设计的EPA（在门诊环境中对一个简单的皮肤病问题进行识别、治疗和护理）。该调查包含两个与EPA一致的假设临床病例。这些问题的目的是确定居民是否以及何时应该要求监督。调查结果：24名居民（56%）和19名居民（79%）完成了调查。大多数住院医师（65%）和PD（63%）证实，有能力的皮肤科住院医师（4级）通常可以在没有监督的情况下进行EPA1，尤其是在看全科医生的患者时。然而，在大学医疗中心工作的四级居民中，仍有相当一部分（36%）表示，他们必须要求对这些患者的评估进行监督。对于第二种意见，结果通常相反。讨论和结论：本研究表明，至少在一个专业和一个国家，引入EPA和委托决策程序通常会导致居民的预期自治。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.