可信賴專業活動之概念分析

Entrustable Professional Activities (EPAs): A Conceptual Analysis

10.29494/LN.202209_23(3).0004

劉梨榛(Li-Chen Liu)；賴維淑(Wei-Shu Lai)

可信賴專業活動 ； 概念分析 ； entrustable professional activities ； concept analysis

領導護理

23卷3期（2022 / 09 / 01）

48 - 58

繁體中文

可信賴專業活動（Entrustable Professional Activities, EPAs）是將學員應學習的核心能力以常見的臨床任務具體呈現、定義、評核與回饋的過程，評估學員是否足以信賴獨立執行某臨床任務，依據學員臨床能力給予不同程度的督導，並提供個別化的精準教學。但EPAs為一項嶄新的名詞且欠缺明確的概念定義，致使EPAs在醫護教育中之應用產生混淆與疑慮。因此本文依據Walker及Avant（2011）的方法，進行EPAs的概念分析，定義性特徵為（一）專業臨床任務；（二）可訓練且可具體評核；（三）具備對應的知識、技能和態度；（四）整合多重核心能力之情境化應用；（五）信賴決定。並透過列舉典型案例、邊緣案例、相關案例、相反案例，以釐清概念、確認前置因子與後果。本文期望能提供對EPAs概念的瞭解，有助於能力導向醫護教育課程設計，引導學習者達成EPAs所涉及的能力。

Entrustable Professional Activities (EPAs) is a process regarding the performance, definition, evaluation and feedback on the core competencies that students should learn when performing common clinical tasks. EPAs can be used to assess whether students can be trusted to perform certain clinical tasks independently. The level of supervision is based on the student's clinical competencies, and hence providing individualized teaching accurately. However, EPAs is a brand-new concept and lacks a clear conceptual definition, which causes confusion and misused in terms of the application in medical education. Hence, this paper conducts a concept analysis of EPAs using the method proposed by Walker and Avant (2011), and defines the characteristics of EPAs as described as following: (1) a mission of professional practice; (2) trainable and evaluable practices; (3) equipped specific knowledge, skills and attitudes; (4) integrated application of multiple core competences; and (5) reliable decisions. This paper also confirms the predisposing factors and consequences of EPAs by listing examples of typical case, borderline case, relevant case, and oppose case. This paper intends to provide an understanding of the concepts of EPAs in assisting competency-based healthcare training, and guide learners to achieve competencies related in EPAs.

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