李丽丽　　谢娜　　邓建中

[关键词] 可信赖式专业活动;岗位胜任力;神经内科;住院医师;规范化培训

[中图分类号] G642.0          [文献标识码] B          [文章编号] 1673-9701（2021）21-0158-04

Application of reliable professional activities in standardized training of neurology resident doctors

LI Lili1   XIE Na2   DENG Jianzhong2

1.Henan Vocational College of Nursing， Anyang   455000， China; 2.Anyang District Hospital of Puyang City， Anyang  455000， China

[Abstract] Under the competency oriented medical education concept， various training and evaluation models of standardized training for resident doctors aim at improving the competency of prescribed training physicians. The post competence needs to be acquired continuously in practice and judged through the professional activities performed by the prescribed training physicians. Reliable professional activities （EPAs）， as a means of evaluating physicians′ competence， are the central link between clinical practice and competence， and are used to evaluate the degree to which resident doctors can independently complete professional tasks after completing training. Through the evaluation of the degree of prescribed training physicians practicing professional activities， the feedback and guidance can be carried out in a purposeful and targeted way， so as to promote the improvement of physicians′ competence.

[Key words] Reliable professional activities （EPAs）; Post competence; Department of Neurology; Resident doctor; Standardized training

医学人才的教育离不开三个连续的阶段性教育，院校教育、毕业后医学教育及继续医学教育。院校教育是基础，为培养医师打好基础，毕业后的医学教育重在医院，经过系统性、规范性的住院医师培训，使之能够具备临床专科所需的临床岗位胜任力。叶燕青等[1]构建了住院医师岗位胜任力的框架，其中包含职业精神、患者管理、交流与团队协作、医疗质量保障及学术科研5个方面。2018年9月，在国家卫健委的支持下及中国住院医师培训教学医院联盟的通力协助，我国《住院医师核心胜任力框架共识》发布，将职业素养、知识技能、患者照護、沟通合作、教学能力、终生学习六个方面纳入住院医师核心的胜任力，阐述了现阶段住院医师培训的根本目标。神经病学不同于其他注重理论的学科，其实践性强，且由于神经疾病表现多样化、病种繁多且复杂、治疗效果不明显、致残率高等特点，因而神经内科住院医师培训更需要强调和突出岗位胜任力的要求[2]。基于胜任力为导向的可信赖式专业活动（entrustable professional activities，EPAs）是临床实践与胜任力联系的中枢纽带，有助于规培医师的岗位胜任力的培养及提升。

1 以胜任力为导向的规培医师的培养及评价模式

1 .1培养模式

在岗位胜任力医学教育（competency-based medical- education，CBME）的大背景下，扬州大学医学院不断地探索与改进，以提高岗位胜任力为宗旨，构建了具有自身特色的人才培养路径[3]。……