護理領域可信賴專業活動之發展──從理論到應用

Development of Entrustable Professional Activities (EPAs) in Nursing: from Theory to Application

以能力導向的醫學教育方式，取代傳統以知識為導向的教學策略，而如何讓訓練課程中的核心能力轉化為工作職場上的勝任能力，已成為當前醫學教育的趨勢。可信賴專業活動意涵，當學員能被信任獨立執行特定醫療行為即是達到足夠勝任能力的具體表現，強調在臨床環境中醫療團隊提供安全有效照護的能力。為彌合基於能力的教育、實踐和知識、技能和態度的實施之間的差距，藉由能力為基礎建構護理臨床教師的可信任的專業活動，屏棄傳統的分數或等第作為評估的尺規，轉而以監督及信賴等級的描述為評估的結果；透過這樣的轉變，可以讓教育訓練的目標與臨床照護及病人安全緊密羅織連結，運用可信賴專業活動架構，有助學員達到臨床教育的核心價值目標，病人得到安全完善的照顧。因此，瞭解可信任的專業活動的建置，將有助於我們在護理領域以勝任能力為導向的護理教育的推廣和實施。

The medical education system is shifting from knowledge-oriented teaching methodologies toward competency-based education that emphasizes translating core competencies learned from training courses into clinical settings. The Entrustable Professional Activities (EPAs) were developed to determine whether learners have sufficient competency to perform specific acts independently, which emphasizes to provide safe and effective care in a clinical setting. To ensure the professional development of trainees, clinical educators must consider multiple factors when they are assigning clinical tasks to trainees and determining the level of supervision required for each task. To bridge the gaps between competency-based education, clinical practice, and the development of knowledge, skills, and attitudes, EPAs can be utilized to translate competencies into clinical practice. Understanding the construction of EPAs can help us to romote and implement competency-based medical education in nursing education.