中国全科医学 ›› 2026, Vol. 29 ›› Issue (34): 5125-5131.DOI: 10.12114/j.issn.1007-9572.2023.0464

• 论著·全科医学教育研究 • 上一篇    

全科医生置信职业行为评价框架的初步应用研究

齐殿君, 于晓松*()   

  1. 110001 辽宁省沈阳市,中国医科大学附属第一医院全科医学科
  • 收稿日期:2025-08-03 修回日期:2026-01-30 出版日期:2026-12-05 发布日期:2026-10-26
  • 通讯作者: 于晓松

  • 作者贡献:

    齐殿君进行项目设计、项目实施、论文撰写;于晓松进行项目设计、实施监督、论文审阅,对文章整体负责。

  • 基金资助:
    辽宁省医学教育研究项目(2022-N007-02); 辽宁省研究生教育科学研究课题(LNYJG2022299); 辽宁省普通高等教育本科教学改革研究项目(20221015925); 中国医科大学教学改革课题(YDJG20240053)

Preliminary Application of the Entrustable Professional Activities Framework for General Practitioners

QI Dianjun, YU Xiaosong*()   

  1. Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
  • Received:2025-08-03 Revised:2026-01-30 Published:2026-12-05 Online:2026-10-26
  • Contact: YU Xiaosong

摘要: 背景 目前国内外全科医生置信职业行为(EPAs)评价框架已经构建,但全科医生EPAs评价框架的实践研究鲜见。 目的 通过实践研究初步评价中国全科医生EPAs评价框架的合理性和可行性。 方法 2021年9月—2022年1月以国内6家全科医学住院医师规范化培训基地的全科医学住院医师为研究对象。应用中国全科医生EPAs评价框架对全科医生的岗位胜任力进行评价和反馈,采用多元线性回归分析探索全科医生EPAs的影响因素。 结果 选取141名全科医学住院医师纳入本研究。平均分最低的是EPA22临床教学,平均分最高的是EPA13重点人群保健。30岁以下全科医学住院医师的总成绩为(141.30±33.73)分,30岁及以上全科医学住院医师的总成绩为(150.01±25.04)分,两人群得分比较,差异无统计学意义(P>0.05)。男住院医师的总得分为(146.63±27.29)分,女住院医师的总得分为(143.73±32.42)分,两人群得分比较,差异无统计学意义(P>0.05)。有既往临床工作经历住院医师的总得分为(149.44±28.07)分,没有既往临床工作经历住院医师的总得分为(137.60±33.69)分,两人群得分比较,差异无统计学意义(P<0.05)。一、二、三年级住院医师的EPAs总得分分别为(113.43±22.07)分、(134.00±16.72)分和(174.94±12.35)分;一、二和三年级住院医师的总得分和各EPAs得分比较,差异有统计学意义(P<0.001)。本科学历住院医师的总得分为(148.38±28.87)分,研究生住院医师的总得分为(139.28±33.14)分,两人群得分比较,差异无统计学意义(P>0.05)。东北、华北、华东、中南、西南、西北六大地域全科医学住院医师的总得分分别是(139.32±26.55)分、(153.43±28.61)分、(148.15±33.44)分、(144.83±35.11)分、(143.30±34.60)分和(142.93±34.09)分,上述各地域得分比较,差异无统计学意义(P>0.05)。多元线性回归分析结果显示,工作经历和轮转年级是全科医生EPAs的影响因素(P<0.05)。反馈结果显示,80.0%以上的住院医师和师资认为EPAs很重要,EPAs评价框架比较全面、具体,较好地反映了全科医师岗位胜任力的要求,具有较好的可行性。 结论 中国全科医生EPAs评价框架具有较好的合理性和可行性。今后将开展多中心长期连续性实践研究以进一步检验,为将来完善EPAs评价框架提供依据。

关键词: 全科医学, 全科医生, 置信职业行为, 岗位胜任力, 教学评价

Abstract:

Background

At present, an entrustable professional activities (EPAs) framework of general practitioners has been constructed at home and abroad. But there are few practical studies on the EPAs framework of general practitioners.

Objective

To understand the rationality and feasibility of EPAs framework for Chinese general practitioners through practical research.

Methods

Residents in 6 residency training bases for general practitioners in China from September 2021 to January 2022 were included in the study. The post competency of general practitioners was evaluated and fed back by the EPAs of Chinese general practitioners, using multiple linear regression analysis to explore the influencing factors of EPAs for general practitioners.

Results

A total of 141 general practice residents were included in the study. With a total average score of 144.57 points, the lowest average score was graded in the EPA22 clinical teaching, and the highest score was graded in the EPA13 key population healthcare . The total score of general practice residents under 30 years old and older than 30 years of age was (141.30±33.73)points, and (150.01±25.04) points, respectively. No significant difference in the total score was detected between them (P>0.05). The total score of male and female residents was comparable [(146.63±27.29)points vs (143.73±32.42) points, P>0.05]. The total score of residents with previous clinical work experience was significantly higher than those without previous clinical work experience [(149.44±28.07) points vs(137.60±33.69) points, P<0.05]. The total EPAs scores of first-year, second-year and third-year residents were (113.43±22.07) points, (134.00±16.72) points and (174.94±12.35) points, respectively. The total scores and EPA scores of first-grade, second-grade and third-grade residents showed a gradually increasing trend, and the pairwise difference between groups was significantly different(P<0.001). The total score of undergraduate resident physicians and graduate resident physicians was not statistically significant [(148.38±28.87) points vs(139.28±33.14) points, P>0.05]. The total scores of general practice residents in Northeast China, North China, East China, South Central China, Southwest China and Northwest China were (139.32±26.55) points, (153.43±28.61) points, (148.15±33.44) points, (144.83±35.11) points, (143.30±34.60) points and (142.93±34.09) points, respectively. There was no significant difference in the total score of regional distribution (P>0.05). The results of the multiple linear regression analysis showed that work experience and rotation grade are influencing factors for EPAs of general practitioners (P<0.05). The feedback results showed that more than 80% of residents and teachers believed that EPAs evaluation was very important. The EPAs framework was comprehensive and specific, which reflected the competency requirements of general practitioners with a good feasibility.

Conclusion

The EPAs framework for Chinese general practitioners has good rationality and feasibility. In the future, multi-center long-term continuous practice studies will be carried out to further test our findings and provide a basis for improving the evaluation framework.

Key words: General practice, General practitioner, Entrustable professional activities, Job competency, Medical evaluation

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