可信賴專業活動於進階護理教育的未來──課程設計和臨床能力的發展

Entrustable Professional Activities in Advanced Nursing Education: Implications for Curriculum Design and Clinical Competency Development

「可信賴專業活動」可視為一個能力評估的架構，將臨床能力轉譯成臨床活動和任務，每個專業需要確認哪些專業活動是他們的核心或是關鍵，期待被訓練者在執行這些專業活動的能力是達到可被信賴的程度。應用於進階護理實務教育時，「可信賴專業活動」的發展是找出進階護理師在特定臨床環境中需獨立執行的實際職責或重要任務，然後對應相關的核心能力，以設計教育訓練課程與評估的標準。「可信賴專業活動」是一種實用且以能力為基礎的方法，用於評估專業教育中的臨床勝任能力。導入「可信賴專業活動」於進階護理教育，除了可以定位進階護理師的角色與功能，確認其核心能力以回應臨床任務的要求，縮短教與用的落差，對於進階護理師在臨床的專業發展提供一個希望的架構。然而，「可信賴專業活動」在護理教育的應用還在啟蒙階段，這篇文章回顧「以能力為導向的教育」重要概念和「可信賴專業活動」的發展策略，聚焦應用於護理進階教育的前瞻性和挑戰。

Entrustable professional activities (EPAs) represent a structured framework for competency-based assessment that operationalizes clinical competencies into observable and measurable clinical activities or tasks. Thus, delineating the activities considered core or critical to practice in a particular profession is critical, with the expectation that trainees will achieve a level of competence sufficient to perform each activity independently and with a high degree of trust. In the context of advanced nursing education, developing EPAs involves identifying the key responsibilities and critical tasks that advanced practice nurses (APNs) must carry out autonomously in specific clinical settings. These tasks are aligned with relevant core competencies to inform the design of educational curricula and assessment standards. EPAs thus provide a practical, competency-oriented approach to evaluating clinical performance in professional training. Integrating EPAs into advanced nursing education not only helps define the roles and scope of APNs but also clarifies the core competencies needed to meet the demands of clinical practice. This alignment helps bridge the gap between education and clinical practice, offering a structured pathway for the professional development of APNs. However, the use of EPAs in nursing education remains in its early stages. In this article, the author reviews key concepts of competency-based education and explores strategies for developing EPAs, with a focus on the anticipated advantages and challenges associated with implementing this framework to advance nursing education.