臺灣麻醉專科導入可信賴專業活動於里程碑計畫

Preliminary Outcomes of Integrating Anesthesiology Milestone Project with Entrustable Professional Activities in Taiwan

本文旨在介紹CBME在臺灣麻醉專科領域之先期導入歷程，分三方面說明近期CBME在不同機構中所採取之路徑，（一）「臺灣麻醉專科milestone指標在地化建置」：邀請全國專家代表經由三次驗證歷程，透過德懷術問卷形塑共識，獲得在地化增修之麻醉科milestone指標。（二）「單一機構執行shift-based milestone之先導研究」：經由簡化、雲端化的創新設計，嘗試在日常工作中融入milestones評核。（三）「全國milestone-based EPAs之藍圖」：首創涵蓋25項milestones次核心能力之EPAs，使評量更貼近臨床。以上教學介入策略皆為降低CBME推動之阻力，經由探索其背景脈絡，檢視推動之初期成果，並在其所遭遇之困境中反思下一階之策略與方向，為確保麻醉專科醫師訓練品質與病人安全嚴格把關。

This article introduced the preliminary outcomes of three approaches adopted for CBME implementation in the field of Anesthesiology in Taiwan. First, a three-round Delphi national survey has been carried out for shaping consensus and developing a local version of Milestone indicators. Second, a simplified, cloud-based milestone has been merged to anesthetic work shift. Third, all 25 Anesthesiology subcompetencies have been deliberately covered by 6 EPAs for evaluating an anesthesiologist’s clinical competence. The aforementioned three contextually derived strategies aim at minimizing resistance to change, ensuring quality of resident training and patient safety.