Entrustable professional activities for quality and patient safety

2018 ◽  
Vol 66 (3) ◽  
pp. 237-243 ◽  
Author(s):  
Laura M. Wagner ◽  
Mary A. Dolansky ◽  
Robert Englander
2017 ◽  
Vol 9 (5) ◽  
pp. 588-592 ◽  
Author(s):  
R. Ellen Pearlman ◽  
Melissa Pawelczak ◽  
Andrew C. Yacht ◽  
Salaahuddin Akbar ◽  
Gino A. Farina

ABSTRACT Background  The Association of American Medical Colleges describes 13 core entrustable professional activities (EPAs) that every graduating medical student should be expected to perform proficiently on day 1 of residency, regardless of chosen specialty. Studies have shown wide variability in program director (PD) confidence in interns' abilities to perform these core EPAs. Little is known regarding comparison of United States Medical Licensing Examination (USMLE) scores with proficiency in EPAs. Objective  We determined if PDs from a large health system felt confident in their postgraduate year 1 residents' abilities to perform the 13 core EPAs, and compared perceived EPA proficiency with USMLE Step 1 and Step 2 scores. Methods  The PDs were asked to rate their residents' proficiency in each EPA and to provide residents' USMLE scores. Timing coincided with the reporting period for resident milestones. Results  Surveys were completed on 204 of 328 residents (62%). PDs reported that 69% of residents (140 of 204) were prepared for EPA 4 (orders/prescriptions), 61% (117 of 192) for EPA 7 (form clinical questions), 68% (135 of 198) for EPA 8 (handovers), 63% (116 of 185) for EPA 11 (consent), and 38% (49 of 129) for EPA 13 (patient safety). EPA ratings and USMLE 1 and 2 were negatively correlated (r(101) = −0.23, P = .031). Conclusions  PDs felt that a significant percentage of residents were not adequately prepared in order writing, forming clinical questions, handoffs, informed consent, and promoting a culture of patient safety. We found no positive association between USMLE scores and EPA ratings.


2013 ◽  
Vol 3 (5) ◽  
Author(s):  
Darrell G. Kirch ◽  
◽  
David A. Davis ◽  
Linda A. Headrick ◽  
Nancy Davis ◽  
...  

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S95-S96
Author(s):  
R Demkowicz ◽  
S Sapatnekar ◽  
D Chute

Abstract Introduction/Objective Since the start of the new millennium, optimization of Quality and Patient Safety (QPS) has taken a renewed focus in the healthcare industry. Consequently, the Accreditation Council for Graduate Medical Education has mandated that QPS be a part of residency training. We have previously presented our curriculum designed to meet the specific needs of Pathology training programs, and covering four content areas: Handoffs, Error Management, Laboratory Administration, and Process Improvement. We are now presenting implementation. Methods To implement this curriculum, we 1) created online modules for self-directed learning on basic topics (using courses developed by IHI and CAP, and assigned articles), and paired these with faculty-facilitated interactive learning activities on more complex topics, including proficiency testing, root cause analysis and test utilization, 2) assigned every resident to a QPS project that was aligned with departmental priorities, led by a faculty advisor, and ran over 8- 10 months, and 3) appointed a QPS Chief Resident to coordinate and support the residents’ QPS activities. We measured the impact of the curriculum by comparing RISE laboratory accreditation percentiles and QPS curriculum quiz scores before and after curriculum implementation. Results After its implementation, RISE percentiles increased by at least 25 for every PGY, and QPS quiz scores increased by at least 10% for 3 of 4 PGY. Every QPS project was presented at Grand Rounds, and 4 were presented externally, including 2 at national conferences. Conclusion Our curriculum was successful in improving residents’ knowledge and competence in QPS. Challenges included designing appropriate learning activities, tracking completion of activities, coordinating faculty schedules and maintaining resident buy-in to the curriculum. We believe that the basic structure of our curriculum offers a solid foundation to which revisions can be made as QPS priorities evolve, and which can be readily adapted to other programs and locations.


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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