scholarly journals Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

2017 ◽  
Vol 9 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Debra Pugh ◽  
Rodrigo B. Cavalcanti ◽  
Samantha Halman ◽  
Irene W. Y. Ma ◽  
Maria Mylopoulos ◽  
...  

ABSTRACT Background The entrustable professional activity (EPA) framework has been identified as a useful approach to assessment in competency-based education. To apply an EPA framework for assessment, essential skills necessary for entrustment to occur must first be identified. Objective Using an EPA framework, our study sought to (1) define the essential skills required for entrustment for 7 bedside procedures expected of graduates of Canadian internal medicine (IM) residency programs, and (2) develop rubrics for the assessment of these procedural skills. Methods An initial list of essential skills was defined for each procedural EPA by focus groups of experts at 4 academic centers using the nominal group technique. These lists were subsequently vetted by representatives from all Canadian IM training programs through a web-based survey. Consensus (more than 80% agreement) about inclusion of each item was sought using a modified Delphi exercise. Qualitative survey data were analyzed using a framework approach to inform final assessment rubrics for each procedure. Results Initial lists of essential skills for procedural EPAs ranged from 10 to 24 items. A total of 111 experts completed the national survey. After 2 iterations, consensus was reached on all items. Following qualitative analysis, final rubrics were created, which included 6 to 10 items per procedure. Conclusions These EPA-based assessment rubrics represent a national consensus by Canadian IM clinician educators. They provide a practical guide for the assessment of procedural skills in a competency-based education model, and a robust foundation for future research on their implementation and evaluation.

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Leigh M. Vanderloo ◽  
Shelley M. Vanderhout ◽  
Erika Tavares ◽  
Jonathon Maguire ◽  
Sharon Straus ◽  
...  

AbstractEvidence generated from partnering with parents to design and conduct research together may be used to refine, adjust, and modify future research approaches. This study aimed to describe the initial approaches to parent engagement in the design of the PARENT trial as well as understand parent perspectives on the acceptability and relevance of the PARENT trial and potential barriers and facilitators to participation.Parents participating in the TARGet Kids! cohort were invited to participate in a focus group, called the PARENT panel, to co-design the PARENT trial. This focus group was conducted to capture diverse individual and collective parents’ experiences. Overall methodological approaches for the PARENT panel were informed by the CIHR Strategy for Patient Oriented Research (SPOR) guiding principles (mutual respect, co-building, inclusiveness, and support) for patient engagement in research, and facilitated through the Knowledge Translation Program in the Li Ka Shing Knowledge Institute at Unity Health Toronto. Using a Nominal Group Technique, the PARENT panel provided feedback on the feasibility, relevance, and acceptability of the proposed intervention. Findings from this work will be used to further refine, adjust, and modify the next iteration of the PARENT trial, which will also serve as an opportunity to discuss the efforts made by researchers to incorporate parent suggestions and what additional steps are required for improved patient engagement.


Author(s):  
Wenxia Wu ◽  
Brian C. Martin ◽  
Chen Ni

Quality healthcare cannot be achieved without competent health professionals. Competency-based education (CBE) is an educational delivery option that may prove to be effective in meeting that need. Through a systematic literature review using content analysis techniques, this chapter explores the conceptual complexity and operational challenges of using CBE in health professions education. Drawing a picture of how competencies are defined and developed in the context of health professions education, this chapter summarizes current practices of integration, delivery, and assessment of competencies. Challenges, emerging trends, and future research directions are also identified. This review found that, unlike in medical education, there are different sets of competencies for most various healthcare disciplines and sub-disciplines and this review suggests that CBE can be a viable model that will enable health professions education to address the diverse needs of health professionals.


2022 ◽  
pp. 193-208
Author(s):  
Naomi Rose Boyer ◽  
Jessica Mason ◽  
Michelle Navarre Cleary ◽  
Julie A. Telkamp

At a time when workplace skills are rapidly evolving, continuous learning is increasingly important, and the responsibility for learning has shifted from others (parents, schools, teachers, employers) to individuals. Self-directed learning (SDL) can help learner-earners thrive in a skills-based economy. Competency-based education (CBE) is well suited to appeal to self-directed learners and to scaffold learner self-direction; however, existing research on the relationship between SDL and CBE programs is limited. This chapter uses case studies of the experiences of two self-directed learners in a CBE program to explore the role of self-direction in their learning journeys. The key takeaways are that (1) self-direction can have a strong impact on learner success and (2) CBE programs are uniquely positioned to support self-directed learners. The chapter concludes with a discussion of considerations for future research.


2018 ◽  
Vol 16 ◽  
pp. 147997311881644 ◽  
Author(s):  
Lisa Jane Brighton ◽  
India Tunnard ◽  
Morag Farquhar ◽  
Sara Booth ◽  
Sophie Miller ◽  
...  

Chronic breathlessness is highly distressing for people with advanced disease and their informal carers, yet health services for this group remain highly heterogeneous. We aimed to generate evidence-based stakeholder-endorsed recommendations for practice, policy and research concerning services for people with advanced disease and chronic breathlessness. We used transparent expert consultation, comprising modified nominal group technique during a stakeholder workshop, and an online consensus survey. Stakeholders, representing multiple specialities and professions, and patient/carers were invited to participate. Thirty-seven participants attended the stakeholder workshop and generated 34 separate recommendations, rated by 74 online survey respondents. Seven recommendations had strong agreement and high levels of consensus. Stakeholders agreed services should be person-centred and flexible, should cut across multiple disciplines and providers and should prioritize breathlessness management in its own right. They advocated for wide geographical coverage and access to expert care, supported through skills-sharing among professionals. They also recommended recognition of informal carers and their role by clinicians and policymakers. Overall, stakeholders' recommendations reflect the need for improved access to person-centred, multi-professional care and support for carers to provide or access breathlessness management interventions. Future research should test the optimal models of care and educational strategies to meet these recommendations.


2005 ◽  
Vol 28 (4) ◽  
pp. 428-446 ◽  
Author(s):  
Julie A. Mcdougal ◽  
C. Michael Brooks ◽  
Mark Albanese

Pediatric Pulmonary Centers (PPCs) are federally funded interdisciplinary leadership training programs aiming to improve the health of families and children. This article describes the process PPCs used to efficiently and effectively achieve consensus on leadership training competencies and outcome measures among a large and diverse group of health professionals. Phase 1 used a modified Delphi technique to develop an initial set of competencies and outcome measures. Phase 2 used the nominal group technique and modified focus group strategies to refine and prioritize the competencies and outcomes measures. Participants reported being highly satisfied with the process and outcomes. In Phase 3, a formal program evaluation instrument was implemented, designed to measure the competency and describe the career paths and leadership accomplishments of previous trainees. The consensus process adopted can serve as a model for academic and public health entities seeking to achieve consensus on program goals, strategies, methods, priorities, and outcomes.


2019 ◽  
Author(s):  
Adanna Chukwuma ◽  
Uche Obi ◽  
Ifunanya Agu ◽  
Chinyere Mbachu

Abstract Background: Variation in clinical performance is attributable to factors outside academic and clinical skills. Selection processes and training programs for medical professionals should be adapted to consider these behavioral factors, which may vary across contexts. This study was conducted to identify behavioral competencies considered relevant for effective medical practice among medical students and practitioners in Nigeria.Methods: We drew on a scoping review to develop a starting list of behavioral attributes that correlate with effective service provision. Drawing on nominal group technique exercises with 17 medical students and 11 physicians, this starting list was modified with scoring and ranking of selected competencies. We compared the list of competencies and rankings between medical students, doctors, and the scoping review.Results: The scoping review identified nine articles for full-text review, resulting in a starting list of 21 behavioral competencies defined in studies conducted in non-African countries. The nominal group technique exercises conducted with medical students and doctors yielded a condensed list of 32 and 27 behavioral competencies respectively. For doctor-client interactions, the behavioral competencies considered most important included effective communication and patient-centeredness. Whereas, for doctor-colleague interactions, team work, respectfulness, and management ability were ranked highly. However, there were clear divergences between groups and with the scoping review.Conclusions: This study is one of the first to identify the perspectives of medical students and physicians on behavioral competencies considered essential for effective medical practice in an African country. We found differences in the perspectives of medical physicians and students, and in the prioritized competencies across contexts. This illustrates the need for careful consideration in identifying subject matter experts and in generalizing competencies across contexts. Future research in this field in Nigeria should examine effective ways of testing for key behavioral competencies among medical students and for residency programs. Also, investigating the perspectives of medical faculty and administrators on important competencies, and exploring the generalizability of these competencies across cultures in Nigeria should be considered.


2021 ◽  
Vol 8 ◽  
pp. 237428952110417
Author(s):  
Bronwyn H. Bryant

Entrustable professional activities are an intuitive form of workplace-based assessment that can support competency-based medical education. Many entrustable professional activities have been written and published, but few studies describe the feasibility or implementation of entrustable professional activities in graduate medical education. The frozen section entrustable professional activit was introduced into the pathology residency training at the University of Vermont for postgraduate year 1 at the start of their training in frozen section. The feasibility of the entrustable professional activit was evaluated based on 3 criteria: (a) utilization, (b) support of frozen section training, and (c) generating data to support entrustment decision about residents’ readiness to take call. The entrustable professional activit was well utilized and satisfactory to residents, faculty, pathologists’ assistants, and Clinical Competency Committee members. Most members of the Clinical Competency Committee agreed they had sufficient data and noted higher confidence in assessing resident readiness to take call with the addition of entrustable professional activit to the residents’ assessment portfolio. Residents did not endorse it helped them prepare for call; however, the interruption to frozen section training due to the COVID-19 pandemic was a significant contributing factor. The frozen section entrustable professional activit is a feasible addition to pathology resident training based on utilization, support of training, and generation of data to support entrustment decisions for graduated responsibilities. The implementation and integration of the entrustable professional activit into pathology training at our institution is described with discussion of adjustments for future use.


2021 ◽  
Author(s):  
Peterson Kato Kikomeko ◽  
Sophie Ochola ◽  
Archileo N. Kaaya ◽  
Irene Ogada ◽  
Tracy Lukiya Birungi ◽  
...  

Abstract Background: Competency-based education (CBE) equips health professionals with the requisite competencies for health systems performance. This study aimed to develop and validate a CBE model suitable for teaching Human Nutrition/Human Nutrition and Dietetics (HN/HND) at the undergraduate level in Uganda. Methods: The study was undertaken in two main phases, (1) competency needs assessment and (2) model development and content validation. The later had three iterative stages: a needs assessment results validation workshop; an expert focus group discussion to develop a draft CBE model framework; and consensus development-itself undertaken in two modified Delphi rounds to ascertain participant consensus on the relevance and suitability of the competency domains, subdomains, and statements comprised in the developed draft CBE framework for undergraduate HN/HND training in Uganda. In the modified Delphi process, participants indicated the degree to which they agreed or disagreed with each of the given statements on five-point Likert-type items of strongly disagree, disagree, neither agree nor disagree, agree, and strongly agree as well as the level of training they recommended the given competency statement to be learned. The workshop had 31 participants, the focus group eight, while the first and second Delphi rounds had 70 and 55 participants respectively. Results: In total, seven competency domains, 24 subdomains, and 190 competency statements were developed. Content analysis and analysis of percentage responses for each competency statement were done with participant consensus set at ≥80%. All the seven domains (100%); 22 (91.7%) of the 24 subdomains; and 153 (87.9%) of the 174 analysed competency statements were evaluated as both relevant and suitable for undergraduate HN/HND training and hence included in the validated CBE model. Conclusion: This study evaluated the relevancy and suitability of seven competency domains prevention and management of malnutrition; nutrition in the lifecycle; food security, food safety, agriculture, and livelihoods promotion; ethics and professionalism in nutrition and dietetics; research and data analysis; policy, advocacy, and social and behaviour change communication; and nutrition leadership and management for undergraduate HN/HND training in Uganda. The study recommends translating the developed CBE model into a standard curriculum that can be taught and evaluated.


2017 ◽  
Vol 28 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Lindsey M. Dorflinger ◽  
Sanjay Kulkarni ◽  
Carrie Thiessen ◽  
Sharon Klarman ◽  
Liana Fraenkel

The need for kidneys for transplantation continues to far surpass the number of donors. Although studies have shown that most people are aware of and support the idea of living donation, it remains unclear what motivates individuals who are aware, knowledgeable, and in support of donation to actually donate, or conversely, what deters them from donating. Utilizing nominal group technique, 30 individuals participated in 4 groups in which they brainstormed factors that would impact willingness to be a living donor and voted on which factors they deemed most important. Responses were analyzed and categorized into themes. Factors that influence the donation decision, from most to least important as rated by participants, were altruism, relationship to recipient, knowledge, personal risk/impact, convenience/access, cost, support, personal benefit, and religion. Participants reported a significant lack of information about donation as well as lack of knowledge about where and how to obtain information that would motivate them to donate or help make the decision to donate. Findings suggest that public campaign efforts seeking to increase rates of living donation should appeal to altruism and increase knowledge about the impact (or lack thereof) of donation on lifestyle factors and future health, and transplant programs should aim to maximize convenience and minimize donor burden. Future research should examine whether tailoring public campaigns to address factors perceived as most salient by potential donors reduces the significant gap in supply of and demand for kidneys.


2015 ◽  
Vol 16 (3) ◽  
pp. 153-164 ◽  
Author(s):  
Jacqueline Kindell ◽  
Karen Sage ◽  
Madeline Cruice

Purpose – The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK. Design/methodology/approach – A nominal group technique was used, followed by further exploration and refinement of issues using a modified Delphi technique with a group of six SLTs who specialised in dementia care and who had experience of working with individuals with semantic dementia and their families. Findings – The findings in the study demonstrate a broader scope of practice than is evident within the research literature with this client group. Therapists identified a range of psychosocial issues for both the person with semantic dementia and their family, in particular finding ways to support activity and participation in conversation and explore barriers and facilitators within the communication environment. Originality/value – This represents the first study to explore everyday practice in this rarer dementia and the information gathered here will be of use to a variety of health and social care professions interested in supporting those with semantic dementia and their families.


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