Abstract:

bjective To construct core entrustable professional activities (EPAs) for undergraduate obstetrics and gynecology internship and evaluate the effect of tiered entrustment combined with electronic portfolios on internship teaching. Methods A single-center prospective quasi-experimental design was used. A total of 68 undergraduate students majoring in Clinical Medicine who undertook obstetrics and gynecology internship from June 2021 to June 2022 were enrolled and divided into a study group and a control group according to rotation batches, with 34 students in each group. The control group received routine apprenticeship teaching and a single end-of-rotation assessment, whereas the study group received a teaching model based on 6 core EPAs, 5-level entrustment, weekly observation and feedback, and whole-process portfolio tracking. The rates of EPA achievement, gain in entrustment level, total score of objective structured clinical examination (OSCE), medical record quality, case presentation quality, teaching satisfaction, feedback timeliness, and portfolio completion were compared between the two groups. Patient experience, team collaboration score, and 8-week competency retention were also evaluated. Results There was no significant difference in the mean EPA score at the beginning of the rotation between the two groups [(1.69±0.28) vs (1.67±0.27), P>0.05]. At the end of the rotation, the mean EPA score of the study group was significantly higher than that of the control group [(3.27±0.33) vs (2.72±0.38), P<0.001]. The overall EPA achievement rate was 82.35% (28/34) vs 50.00% (17/34), and the gain in entrustment level was (1.58±0.34) vs (1.05±0.31), with significant differences between groups (both P<0.01). The study group also achieved higher total OSCE score, medical record quality score, case presentation quality score, and teaching satisfaction score than the control group [(86.47±5.83) vs (79.29±6.41), (89.35±4.72) vs (83.41±5.18), (87.29±5.14) vs (81.06±5.76), and (92.65±4.13) vs (86.18±5.21), respectively; all P<0.001]. In addition, the feedback timeliness rate and portfolio completion rate in the study group were significantly higher than those in the control group [94.85% (129/136) vs 57.35% (78/136), 96.32% (393/408) vs 71.08% (290/408), respectively; both P<0.001]. The patient experience score, team collaboration score, and 8-week overall EPA achievement retention rate were also higher in the study group than in the control group [(93.10±4.02) vs (88.44±5.20), (88.71±4.68) vs (82.06±5.37), and 76.47% (26/34) vs 44.12% (15/34), respectively; all P<0.01]. Conclusion The internship teaching model based on core EPAs, tiered entrustment, and electronic portfolios can improve task performance in authentic clinical settings and the quality of process evaluation among undergraduate students in obstetrics and gynecology, but its stability and generalizability should be further verified in multi-center studies with larger samples.