Wresting with Implementation: a Step-By-Step Guide to Implementing Entrustable Professional Activities (EPAs) in Psychiatry Residency Programs

Author(s):  
Erick K. Hung ◽  
Michael Jibson ◽  
Julie Sadhu ◽  
Colin Stewart ◽  
Ashley Walker ◽  
...  
CJEM ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 803-806
Author(s):  
Emily J. Stoneham ◽  
Lara Witt ◽  
Quinten S. Paterson ◽  
Lynsey J. Martin ◽  
Brent Thoma

ABSTRACTWe designed two practical, user-friendly, low-cost, aesthetically pleasing resources, with the goal of introducing residents and observers to a new Competence by Design assessment system based on entrustable professional activities. They included a set of rotation- and stage-specific entrustable professional activities reference cards for bedside use by residents and observers and a curriculum board to organize the entrustable professional activities reference cards by stages of training based on our program's curriculum map. A survey of 14 emergency medicine residents evaluated the utilization and helpfulness of these resources. They had a positive impact on our program's transition to Competence by Design and could be successfully incorporated into other residency programs to support the introduction of entrustable professional activities-based Competence by Design assessment systems.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Steven Craig ◽  
Hayden Smith ◽  
Julie L. Anderson-Suddarth ◽  
Nicholas J. Galioto ◽  
Corrine M. Ganske ◽  
...  

Background: Entrustable Professional Activities (EPAs) for medical students were designed to help prepare students for the clinical roles of residency training. To date, there have been no published studies examining resident confidence performing the EPAs across the first year of post-graduate training. Objective: To examine self-reported confidence levels of first-year residents performing the 13 activities included in the Core Entrustable Professional Activities for Entering Residency. Methods: Entering allopathic and osteopathic residents from seven residency programs were contacted at the start, and after 3, 6, and 12 months of training to complete an electronic survey self-assessing confidence performing EPAs. Results: All 46 (100%) eligible residents completed surveys at the four study time points for the 13 EPAs, which resulted in 2,392 data points. Residents reported a high level of confidence performing four EPAs (i.e., 1, 5, 6, and 9) at baseline. Conversely, more than two-thirds of residents reported a lack of confidence performing four EPAs (i.e., 4, 8, 12, and 13) at baseline. A significant positive trend in confidence from baseline to 12 months was seen in almost all EPAs. However, more than 10% of residents reported not being confident performing EPAs 12 and 13 at twelve months. Conclusions: Results revealed not all residents reported being confident performing EPAs at the beginning and end of the first year of training. Medical schools need to examine preparation of graduating students in the EPA areas. Residency programs need to assess entering resident competency to determine the need for increased initial supervision and remediation.   Funding/Support: None Ethical approval: The study received approval from the Human Subjects Committee of UnityPoint Health – Des Moines. Conflict of Interest: The authors declare they have no competing interests.


Author(s):  
Jan Riezebos ◽  
Durk Jouke Van der Zee ◽  
Jan Pruim

Residency programs allow residents, i.e., graduate physicians, to qualify for being a specialist in one of the medical disciplines. Their educational programme is strongly focusing on competencies and skills, but will incur a major change in the near future in order to introduce Entrustable Professional Activities (EPA’s). EPA’s focus on actual physician tasks and are assessed by supervisors in the clinic. The trust levels indicate whether trainees are ready for the next milestone, such as unsupervised practice, based on assessment of performance of those activities. EPA’s have not only effect on the internships and the assessment process, but also impact the planning and scheduling of the educational programmes, internships, patient care services, and co-operation between regional hospitals. This study examines the effect on the planning and scheduling process and proposes a framework for planning and scheduling in order to facilitate the organization of this type of educational  programs. The main improvements have to be found in an improved regional coordination between the hospitals, a more leading role for the educational programme directors, and more intelligent planning and scheduling.


2021 ◽  
Vol 61 (3) ◽  
pp. 702-703
Author(s):  
Kashelle Lockman ◽  
Maria Lowry ◽  
Sandra Discala ◽  
Tanya Uritsky ◽  
Amanda Lovell ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Severin Pinilla ◽  
Alexandra Kyrou ◽  
Stefan Klöppel ◽  
Werner Strik ◽  
Christoph Nissen ◽  
...  

Abstract Background Entrustable professional activities (EPAs) in competency-based, undergraduate medical education (UME) have led to new formative workplace-based assessments (WBA) using entrustment-supervision scales in clerkships. We conducted an observational, prospective cohort study to explore the usefulness of a WBA designed to assess core EPAs in a psychiatry clerkship. Methods We analyzed changes in self-entrustment ratings of students and the supervisors’ ratings per EPA. Timing and frequencies of learner-initiated WBAs based on a prospective entrustment-supervision scale and resultant narrative feedback were analyzed quantitatively and qualitatively. Predictors for indirect supervision levels were explored via regression analysis, and narrative feedback was coded using thematic content analysis. Students evaluated the WBA after each clerkship rotation. Results EPA 1 (“Take a patient’s history”), EPA 2 (“Assess physical & mental status”) and EPA 8 (“Document & present a clinical encounter”) were most frequently used for learner-initiated WBAs throughout the clerkship rotations in a sample of 83 students. Clinical residents signed off on the majority of the WBAs (71%). EPAs 1, 2, and 8 showed the largest increases in self-entrustment and received most of the indirect supervision level ratings. We found a moderate, positive correlation between self-entrusted supervision levels at the end of the clerkship and the number of documented entrustment-supervision ratings per EPA (p < 0.0001). The number of entrustment ratings explained 6.5% of the variance in the supervisors’ ratings for EPA 1. Narrative feedback was documented for 79% (n = 214) of the WBAs. Most narratives addressed the Medical Expert role (77%, n = 208) and used reinforcement (59%, n = 161) as a feedback strategy. Students perceived the feedback as beneficial. Conclusions Using formative WBAs with an entrustment-supervision scale and prompts for written feedback facilitated targeted, high-quality feedback and effectively supported students’ development toward self-entrusted, indirect supervision levels.


2021 ◽  
Vol 8 ◽  
pp. 237428952199082
Author(s):  
Kristie White ◽  
Julianne Qualtieri ◽  
Elizabeth L. Courville ◽  
Rose C. Beck ◽  
Bachir Alobeid ◽  
...  

Hematopathology fellowship education has grown in complexity as patient-centered treatment plans have come to depend on integration of clinical, morphologic, immunophenotypic, molecular, and cytogenetic variables. This complexity is in competition with the need for timely hematopathology care with stewardship of patient, laboratory, and societal resources. Accreditation Council for Graduate Medical Education Milestones provide a guidance document for hematopathology training, but fellows and their educators are in need of a simple framework that allows assessment and feedback of growth toward independent hematopathology practice. Entrustable professional activities provide one such framework, and herein, we provide proposed Hematopathology Fellowship Entrustable Professional Activities based on review of pertinent guidelines and literature, with multiple rounds of expert and stakeholder input utilizing a modified mini-Delphi approach. Ten core entrustable professional activities deemed essential for graduating hematopathology fellows were developed together with skills and knowledge statements, example scenarios, and corresponding Accreditation Council for Graduate Medical Education Milestones. Application of these entrustable professional activities in program design, fellow evaluation, and decisions regarding level of supervision is discussed with consideration of benefits and barriers to implementation. These entrustable professional activities may be used by hematopathology fellowship directors and faculty to provide fellows with timely constructive feedback, determine entrustment decisions, provide the Clinical Competency Committee with granular data to support Milestone evaluations, and provide insight into areas of potential improvement in fellowship training. Fellows will benefit from a clear roadmap to independent hematopathology practice with concrete and timely feedback.


Author(s):  
Daniel J. Schumacher ◽  
Abigail Martini ◽  
Benjamin Kinnear ◽  
Matthew Kelleher ◽  
Dorene F. Balmer ◽  
...  

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