Actividades profesionales confiables (APROC) : un enfoque de competencias para el perfil médico

espanolLa implementacion de la educacion basada en competencias ha revolucionado de manera global la forma de aprender y ensenar medicina. Las competencias corresponden a las atribuciones que todo medico debe de poseer, y surgieron a partir de las Canadian Medical Education Directives for Specialists y el Accreditation Council for Graduate Medical Education (ACGME). Para lograr su adquisicion, ha sido necesario implementar las actividades profesionales confiables (APROC), termino acunado por Ten Cate y Scheele, cuya finalidad ha sido vincular el concepto de competencias con la practica. Se trata de actividades clinicas que los aprendices deben realizar para lograr dominarlas sin supervision. El Milestone Project creado por el ACGME surgio para enriquecer las competencias, y cada especialidad debe definir las propias y decidir el nivel de desempeno que espera de sus alumnos en cada ano de la especialidad. Para lograr aplicar las APROC es necesario que su diseno sea acorde con los objetivos del plan de estudios y requisitos del perfil del graduado. Diversas instituciones educativas de diferentes paises han implementado este innovador modelo de ensenanza, entre los que destacan Canada, Estados Unidos, Reino Unido, Australia, Nueva Zelanda y Paises Bajos. El proposito de este articulo es difundir nuevas propuestas para la educacion medica que logren vincular el perfil de competencias con la practica clinica rutinaria, para que los facultativos logren empoderamiento de estas nuevas herramientas y las puedan aplicar de manera eficiente en la ensenanza de los estudiantes, y una de estas son las APROC. EnglishThe implementation of competency-based education has revolutionized the way of learning and teaching medicine globally. Competencies are the responsibilities that all physicians must possess; they emerged from the Canadian Medical Education Directives for Specialists (CanMEDS) and Accreditation Council for Graduate Medical Education (ACGME). To achieve the acquisition of these competencies, it has been necessary to implement Entrustable Professional Activities (EPAs), term coined by Ten Cate and Scheele, its purpose has been to link the concept of competencies with the practice. EPAs are clinical activities that learners must carry out for master them without supervision. The Milestone Project created by the ACGME was founded in order to enrich the competencies, where each specialty should define their own and decide the level of performance expected of students in each postgraduate year of the specialty. To apply the EPAs it is necessary that its design is consistent with the objectives of the curriculum and requirements of the profile of the graduate. Several educational institutions in different countries have implemented this innovative model of teaching, including: Canada, United States of America, United Kingdom, Australia, New Zealand and the Netherlands. The purpose of this article is to spread new proposals for medical education that link the competencies with the daily basis practice in medicine to allow clinicians to achieve empowerment of these new tools and can apply them efficiently to the teaching of students, being one of these tools the EPAs.