Entrustable professional activities (EPAs) for teachers in medical education: Has the time come?

2016 ◽  
Vol 39 (8) ◽  
pp. 894-896 ◽  
Author(s):  
Charlene M. Dewey ◽  
Gersten Jonker ◽  
Olle ten Cate ◽  
Teri L. Turner
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.


2017 ◽  
Vol 4 ◽  
pp. 237428951771428 ◽  
Author(s):  
Cindy B. McCloskey ◽  
Ronald E. Domen ◽  
Richard M. Conran ◽  
Robert D. Hoffman ◽  
Miriam D. Post ◽  
...  

Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity–related assessment and curricular tools for pathology residency training.


2018 ◽  
Vol 10 (01) ◽  
pp. 026-030 ◽  
Author(s):  
Pooja Sharma ◽  
Nadeem Tanveer ◽  
Aditi Goyal

Abstract INTRODUCTION: During the past decade, there has been a paradigm shift in medical education from the problem-based learning to competency-based training. This has forced a rethink on the way we evaluate the residents and finally give them the right to handle patients independently. This study makes the first attempt towards designing competency-based training program for pathology residents by formulating the entrustable professional activities (EPAs) for the 1st year pathology residents. MATERIALS AND METHODS: A questionnaire comprising 18 potential EPAs in histopathology and 12 potential EPAs in cytology were circulated among the residents of Pathology Department. The respondents were asked to grade the EPAs on a scale of 0–4 based on how important they considered that activity as EPA. The cumulative score of each EPA was divided by the number of respondents to arrive at the average score. The EPAs with an average score of 3 or more qualified to be shortlisted as consensus EPAs. RESULTS: Five activities each of histopathology and cytopathology had an average score of 3 or above and were shortlisted as EPAs for the 1st year pathology postgraduates. Each of these was also mapped to their respective competencies. CONCLUSION: There is an urgent need to restructure the postgraduate pathology curriculum in line with competency-based training. This study is the first step in this direction.


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.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Beeri ◽  
F.C Tanner ◽  
O Ten Cate ◽  
M Ros ◽  
P Kirchhof

Abstract   Assessment of trainees is a core activity of educators, ensuring that trainees can be trusted to provide high quality care with no supervision. Training and the demands on trainees have changed with specialization, need for more technical skills, digitization, needs for teamwork and greater communication skills. Competency-based medical education was introduced to capture these changing needs for trainees. The 7th ESC Education Conference – “From competence to good clinical care” – brought together national directors of training (39), young cardiology representatives (7), patients (7), ESC partners in education (10), and the ESC Education Committee (22) to discuss contemporary challenges in cardiology training and Entrustable Professional Activities (EPAs)-based solutions. Methods Pre- and post-conference surveys were conducted. The different issues were discussed in 4 workshops: core knowledge and evidence, skills and competence, performing into context, and training the trainers. Results Pre-conference, 90% of respondents believed that trainees should be certified only when they can be entrusted to perform in an unsupervised fashion, and 84% thought that specific training for educators should be required. From the workshops 4 themes emerged: 1) Core knowledge and evidence: rotations to different centres are needed to enable trainees to meet EPA requirements. 2) Skills and competence: a learning agreement between trainers and trainees should be established with protected time to achieve EPAs, and patient feedback on trainee performance should be obtained. 3) Performing into context (when is a trainee ready to practice): clinicians do informal assessment on a daily basis; EPAs formalize this with regular observation linked with progression in responsibility. 4) Train the trainer: good doctors are not automatically good trainers and should be required to undergo specific training themselves. We reviewed complex training frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) that contains too many components to be useful for clinical teachers. EPAs were identified as a practical way to implement competency-based cardiology training across the ESC. The 2020 ESC Core Curriculum contains EPAs that a cardiologist should be able to perform independently by the end of training. Post-conference there was unanimous agreement (100%) that EPAs are a valuable concept in training. A majority of participants (69%) agreed that EPA's are applicable in practice today. Conclusion Trainee assessment is a daily challenge for educators. The ESC Education Conference identified distinct goals to be achieved before, during and at the completion of a training programs. The EPA concept was widely accepted as an efficient method to monitor trainees progress, while trusting them to perform activities in which they are proficient. Trusting our trainees should be a major educational goals for cardiologists in Europe. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Severin Pinilla ◽  
Eric Lenouvel ◽  
Andrea Cantisani ◽  
Stefan Klöppel ◽  
Werner Strik ◽  
...  

Abstract Background Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. Methods We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. Results We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. Conclusions There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.


MedEdPublish ◽  
2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Samuel Eloy Gutiérrez-Barreto ◽  
Verónica Daniela Durán-Pérez ◽  
Felipe Flores-Morones ◽  
Ricardo Iván Esqueda-Nuñez ◽  
Carlos Abilio Sánchez-Mojica ◽  
...  

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