臨床教師執行可信賴專業活動於畢業後學員評量與回饋

Implementing Entrustable Professional Activity (EPA) Evaluation and Feedback among Clinical Preceptors for Graduated Trainees

可信賴專業活動（entrustable professional activities, EPAs）導入臨床訓練10餘年，著重學員整合照護病人工作能力，及達成工作任務可信賴程度。故本文目的是歸納臨床教師對可信賴回饋形式與內容、實質回饋的影響。以系統性文獻查證，搜尋5年內國內外資料庫，標題和摘要關鍵字英文entrustable professional activity（ies），preceptor（s）and feedback，中文為可信賴專業活動、臨床教師、回饋。結果納入6篇文章，藥學及醫學各3篇共427位臨床教師，年資5年以上。臨床教師督導學員達到可信賴較為純熟，回饋形式具多面向，包括現場及時口頭、書面及EPAs可信賴度分數；回饋內容可看出教師對學員的期待、信賴程度。此外教師教學年資、對EPAs回饋形式熟悉程度等皆對為有效實質回饋因素。本文建議未來各機構可增加臨床教師EPAs教學回饋能力之訓練。

Entrustable professional activity(ies) (EPAs) has been implemented in clinical training for over a decade. EPAs framework focuses on the level of clinical preceptors trusting ＂graduated trainee＂ ability to integrate patient care and achieve the work tasks. Therefore, this article aims to induct the influence of clinical preceptors on the effective feedback form, content. Use systematic literature review, search domestic and foreign databases within five years, and search extensively in titles and abstract keywords including entrustable professional activity(ies), preceptor(s) and feedback in both English and Chinese language. Six articles were included in the analysis , including three articles in pharmacy and medicine, with 427 preceptors with more than five years of teaching experience. We found that the preceptors are more skillful in supervising graduated trainees to be trustworthy and proficient by using multi-faceted feedback forms, including on-site oral, written, and EPAs supervision scores. The feedback content showed that the preceptors' expectations and trust in trainees. Moreover, preceptors' teaching years and familiarity with EPAs feedback forms were practical factors. We suggest institutions to emphasize training clinical preceptors' EPAs teaching feedback ability.