The development of entrustable professional activities reference cards to support the implementation of Competence by Design in emergency medicine

CJEM ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 803-806
Author(s):  
Emily J. Stoneham ◽  
Lara Witt ◽  
Quinten S. Paterson ◽  
Lynsey J. Martin ◽  
Brent Thoma
Keyword(s):  
Emergency Medicine ◽  
Positive Impact ◽  
Low Cost ◽  
Assessment System ◽  
Entrustable Professional Activities ◽  
Design Assessment ◽  
Residency Programs ◽  
Professional Activities ◽  
Curriculum Map ◽  
User Friendly

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.

scholarly journals P101: The development of entrustable professional activity reference cards to support the implementation of Competence by Design in emergency medicine

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S100
Author(s):  
E. Stoneham ◽  
L. Witt ◽  
Q. Paterson ◽  
L. Martin ◽  
B. Thoma
Keyword(s):  
Emergency Medicine ◽  
Low Cost ◽  
Intervention Mapping ◽  
Assessment System ◽  
Professional Activity ◽  
Residency Programs ◽  
Professional Activities ◽  
Competency Based ◽  
Curriculum Map ◽  
User Friendly

Innovation Concept: Competence by Design (CBD) was implemented nationally for Emergency Medicine (EM) residents beginning training in 2018. One challenge is the need to introduce residents to Entrustable Professional Activities (EPAs) that are assessed across numerous clinical rotations. The Royal College's resources detail these requirements, but do not map them to specific rotations or present them in a succinct format. This is problematic as trainees are less likely to succeed when expectations are unclear. We identified a need to create practical resources that residents can use at the bedside. Methods: We followed an intervention mapping framework to design two practical, user-friendly, low-cost, aesthetically pleasing resources that could be used by residents and observers at the bedside to facilitate competency-based assessment. Curriculum, Tool or Material: First, we designed a set of rotation- and stage-specific EPA reference cards for the use of residents and observers at the bedside. These cards list EPAs and clinical presentations likely to be encountered during various stages of training and on certain rotations. Second, we developed a curriculum board to organize the EPA reference cards by stage based upon our program's curriculum map. The curriculum board allows residents to view the program's curriculum map and the EPAs associated with each clinical rotation at a glance. It also contains hooks to hang and store extra cards in an organized manner. Conclusion: We believe that these practical and inexpensive tools facilitated our residency program's transition to competency-based EPA assessments. Anecdotally, the residents are using the cards and completing the suggested rotation-specific EPAs. We hope that the reference cards and curriculum board will be successfully incorporated into other residency programs to facilitate the introduction of their EPA-based CBD assessment system.

Entrustable Professional Activities: Making Sense of the Emergency Medicine Milestones

2014 ◽  
Vol 47 (4) ◽  
pp. 441-452 ◽  
Author(s):  
Michael S. Beeson ◽  
Steven Warrington ◽  
Amber Bradford-Saffles ◽  
Danielle Hart
Keyword(s):  
Emergency Medicine ◽  
Entrustable Professional Activities ◽  
Professional Activities ◽  
Making Sense

Assessment of Entrustable Professional Activities Using an Online Simulation Platform During Transition to Emergency Medicine Residency: A Mixed Methods Pilot Study (Preprint)

2021 ◽  
Author(s):  
Cynthia R Peng ◽  
Kimberly A Schertzer ◽  
Holly A Caretta-Weyer ◽  
Stefanie S Sebok-Syer ◽  
William Lu ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pilot Study ◽  
Final Diagnosis ◽  
Diagnostic Assessment ◽  
Entrustable Professional Activities ◽  
Simulation Platform ◽  
Professional Activities ◽  
Clinical Encounters ◽  
Critical Action ◽  
Competency Based

BACKGROUND The 13 Core Entrustable Professional Activities (EPAs) are key competency-based learning outcomes in the transition from undergraduate to graduate medical education. Five of these EPAs (EPA2: prioritizing differential, EPA3: recommending and interpreting tests, EPA4: entering orders and prescriptions, EPA5: documenting clinical encounters, and EPA10: recognizing urgent and emergent conditions) are uniquely suited for online assessment. OBJECTIVE For this pilot study, we created a web-based simulation platform for diagnostic assessment of these EPAs and examined its feasibility and acceptability. METHODS Four simulation cases underwent three rounds of consensus panels and pilot testing. Incoming emergency medicine interns (n=15) completed all cases, and up to 4 “look for” statements, which encompassed specific EPAs, were generated for each participant: 1) performing harmful or missing actions, 2) narrow differential or wrong final diagnosis, 3) having errors in documentation, and 4) lack of recognition and stabilization of urgent diagnoses. Finally, we interviewed a sample of interns (n=5) and residency leadership (n=5) and analyzed the responses using thematic analysis. RESULTS All participants had at least 1 missing critical action and 40% participants performed at least one harmful action across all 4 cases. The final diagnosis was not included in the differential diagnosis in more than half of assessments (53%). Other errors included choosing the incorrect documentation (40%) and indiscriminately applying oxygen (60%). The themes to the interviews included: psychological safety of the interface, ability to assess learning, and fidelity of cases. The most valuable feature cited was the ability to place orders in a realistic electronic medical record interface. CONCLUSIONS This study demonstrates the feasibility and acceptability of this platform for diagnostic assessment of specific EPAs. This approach rapidly identifies potential areas of concern for incoming interns using an asynchronous format, provides this feedback in a manner appreciated by residency leadership, and informs individualized learning plans.

scholarly journals Integration of Entrustable Professional Activities with the Milestones for Emergency Medicine Residents

2018 ◽  
Vol 20 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Danielle Hart ◽  
Douglas Franzen ◽  
Michael Beeson ◽  
Rahul Bhat ◽  
Miriam Kulkarni ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Entrustable Professional Activities ◽  
Professional Activities

scholarly journals Evaluation of Resident Confidence Performing Entrustable Professional Activities During the First Year of Residency Training

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Steven Craig ◽  
Hayden Smith ◽  
Julie L. Anderson-Suddarth ◽  
Nicholas J. Galioto ◽  
Corrine M. Ganske ◽  
...  
Keyword(s):  
Residency Training ◽  
Graduate Training ◽  
Human Subjects ◽  
Entrustable Professional Activities ◽  
First Year ◽  
Positive Trend ◽  
Residency Programs ◽  
Professional Activities ◽  
Post Graduate Training ◽  
High Level

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.

scholarly journals Impact of an entrustable professional activities-based assessment system

2018 ◽  
Vol 8 (3) ◽  
pp. 1-9
Author(s):  
Megan Lord ◽  
Amanda B Murchison ◽  
Alaina Lawrence ◽  
Isaiah Johnson
Keyword(s):  
Assessment System ◽  
Entrustable Professional Activities ◽  
Professional Activities

scholarly journals Entrustable Professional Activities in Residency Programs – planning and scheduling issues

2019 ◽  
Author(s):  
Jan Riezebos ◽  
Durk Jouke Van der Zee ◽  
Jan Pruim
Keyword(s):  
Major Change ◽  
Educational Programme ◽  
Assessment Process ◽  
Entrustable Professional Activities ◽  
Planning And Scheduling ◽  
Residency Programs ◽  
Professional Activities ◽  
Care Services ◽  
Leading Role ◽  
Regional Coordination

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.

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