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„Entrustable professional activities“

Zukunftsweisendes Konzept für die ärztliche Weiterbildung

Entrustable professional activities

Promising concept in postgraduate medical education

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Zusammenfassung

Als „entrustable professional activity“ (EPA) wird eine in sich abgeschlossene klinische Arbeitseinheit bezeichnet, die für den jeweiligen Arbeitsbereich typisch ist und die im Verlauf der Weiterbildung schrittweise dem Weiterzubildenden zur selbstständigen Durchführung anvertraut wird. Das könnte z. B. die intraoperative Narkoseführung bei einem ASA-1-Patienten für einen unkomplizierten operativen Eingriff sein. Die EPA kann als Weiterentwicklung eines „kompetenzbasierten“ Ausbildungskonzepts verstanden werden, indem die vorhandenen Kompetenzen einer Person auf die konkrete Arbeitssituation bezogen werden. Damit werden die auf einer bestimmten Weiterbildungsstufe erwarteten Fähigkeiten und Fertigkeiten für alle Beteiligten klarer fassbar, und der Gefahr der Fragmentierung von Einzelkompetenzen im „kompetenzbasierten“ Modell wird vorgebeugt. Erfahrungen mit dem Konzept sind derzeit noch begrenzt, sodass dringend Studien notwendig sind, die zeigen, ob und wie EPA zu einer Verbesserung der Weiterbildung beitragen.

Abstract

Entrustable professional activities (EPAs) are characterized as self-contained units of work in a given typical clinical context, which may be entrusted to a trainee for independent execution at a certain point of training. An example could be the intraoperative anesthesia management of an ASA 1 patient for an uncomplicated surgical intervention as an EPA in early postgraduate anesthesia training. The EPAs can be described as an evolution of a competency-based medical educational concept, applying the concept of the competencies of a person to specific workplace contexts. In this way the expected level of skills and supervision at a certain stage of training have a more practical meaning and the danger of fragmentation of individual competencies in the competence-based model is avoided. It is a more holistic view of a trainee. Experience with this new concept is so far limited, therefore, further studies are urgently needed to determine whether and how EPAs can contribute to improvements in further training.

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Notes

  1. Vereinfacht gesagt, führt der Begriff „Kompetenz“ Wissen, Fertigkeiten, Fähigkeiten und Haltungen einer Person zusammen.

  2. „Workplace based assessment“.

  3. „Mini-clinical examination exercise“, arbeitsplatzbasierte Prüfungsform, bei der eine typische klinische Aktivität (z. B. eine Eintrittsuntersuchung) beobachtet und im Anschluss daran ein kurzes Feedbackgespräch geführt wird.

  4. „Directly observed procedural skills“, ebenfalls arbeitsplatzbasierte Prüfungsform, die sich stärker auf eine klinische Prozedur bezieht.

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Authors and Affiliations

  1. Dekanat, Medizinische Fakultät, Universität Zürich, Pestalozzistr. 3/5, 8091, Zürich, Schweiz

    J. Breckwoldt MME

  2. Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Aachen, Deutschland

    S. K. Beckers

  3. Ärztliche Leitung Rettungsdienst Stadt Aachen, Berufsfeuerwehr Aachen, Aachen, Deutschland

    S. K. Beckers

  4. Klinik für Anästhesiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland

    G. Breuer

  5. Institut für Anästhesiologie, UniversitätsSpital Zürich, Zürich, Schweiz

    A. Marty

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  1. J. Breckwoldt MME
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  3. G. Breuer
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  4. A. Marty
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Correspondence to J. Breckwoldt MME.

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J. Breckwoldt, S.K. Beckers, G. Breuer und A. Marty geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Breckwoldt, J., Beckers, S.K., Breuer, G. et al. „Entrustable professional activities“. Anaesthesist 67, 452–457 (2018). https://doi.org/10.1007/s00101-018-0420-y

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