scholarly journals Entrustable Professional Activities for Undergraduate Nutrition Student Clinical Training: Development and Implementation

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 485-485
Author(s):  
Weining Wang ◽  
Ya Ling Wang ◽  
Chao Hsiu Chen ◽  
Yi Jui Chan ◽  
Hui Min Hsieh
Keyword(s):  
Clinical Training ◽  
Credit Rating ◽  
Medical Training ◽  
Medical Center ◽  
Complete Information ◽  
Multisource Feedback ◽  
Entrustable Professional Activities ◽  
Diabetic Patients ◽  
Professional Activities ◽  
Nutrition Care

Abstract Objectives Entrustable professional activities (EPAs) have been applied to postgraduate and undergraduate medical training, but the application of nutrition intern students is rare. The clinical training of nutrition intern students must be connected with the nutrition care ability after graduation. Outpatient diabetes nutrition care is an important job of hospital dietitian. Therefore, this is the good point for the development of EPAs evaluation. The objective of this study was to describe the development of EPAs for nutrition intern training in the nutrition department of a medical center. Methods We chose the topic “Diet and health education for diabetic patients in outpatient clinics” and set the EPAs framework. EPAs was developed through an iterative consensus process involving the advanced dietitians. The content includes task description, capabilities (knowledge, skills, attitudes and behaviors), evaluation information, setting the trust level and validity period. The evaluation was established through expert validity. Final EPAs revisions followed from the multisource feedback. The Clinical Competency Committees (CCC) was established for final evaluation and approval. Results The EPAs was piloted for intern students in the Nutrition Department of the Medical Center from 2019. The assessment methods include test, mini-CEX, ad-hoc EPA, OSCE. The assessment content includes the knowledge of diabetes medical, diet, drug, clinical consultation, education, empathy and attitude, etc. Students were evaluated during each period of training. Finally, all the evaluation results were summarized and the CCC gave each student a credit rating. Conclusions Through multiple evaluations and timely feedback, the ability of intern students was defined in more precision. It allowed clinical teachers to achieve a teaching consensus. Combine competence with actual work, and integrate evaluation with authorization. We need to construct a complete information system to make evaluation more efficient in the future. Funding Sources None.

scholarly journals Could Entrustable Professional Activities mediate teaching-care integration services in the community?

2020 ◽  
Vol 69 (2) ◽  
Author(s):  
Ieda Francischetti ◽  
José Bitu Moreno ◽  
Harm Peters
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Primary Health Care ◽  
Medical Training ◽  
Entrustable Professional Activities ◽  
Professional Activities ◽  
Care Integration ◽  
Primary Health ◽  
Teaching Community ◽  
Competency Based

Currently, competency-based medical education (CBME) is the most common type of curriculum used worldwide. However, its limitations include fragmented learning and difficulties to use properly the knowledge, skills, and attitudes acquired using this educational model. Having this in mind, Entrustable Professional Activities (EPA) emerge as a tool to mediate the transposition of the competency-based curriculum into physicians’ professional practice in graduate medical education. Therefore, based on a narrative review of the existing literature on EPA and the authors’ experience in teaching community-based healthcare integration services, the aim of this paper is to reflect on the possible use of these activities in undergraduate medical education for the development of a CBME model integrated with primary health care and community medicine. The reflections made here allow suggesting that, although it is a challenging process, the adoption of EPA in undergraduate medical training is appropriate to achieve a better provision of primary health care to individuals, families, and communities in general.

scholarly journals An Updated Primer on Entrustable Professional Activities (EPAs)

2019 ◽  
Vol 43 (1 suppl 1) ◽  
pp. 712-720
Author(s):  
Olle ten Cate
Keyword(s):  
Undergraduate Students ◽  
Medical Training ◽  
Specific Activity ◽  
Two Dimensions ◽  
Entrustable Professional Activities ◽  
Turn Of The Millennium ◽  
Professional Activities ◽  
Competency Based ◽  
Almost All ◽  
Indirect Supervision

ABSTRACT Since the turn of the millennium, competency-based medical education (CBME) has become a new standard for medical training in many countries. CBME has been operationalized in detailed frameworks of competencies that every physician should demonstrate at graduation, and similar frameworks have been created for specialties. However, the competencies, describing qualities that physicians should possess, do not directly translate into everyday activities of physicians. For that reason, the Entrustable Professional Activities (EPAs) were introduced. EPAs are units of professional practice that may be entrusted to undergraduate students, once they show the competencies needed to perform them without supervision. EPAs have become a popular topic within CBME programs in many countries and hundreds of publications within only a few years. This paper was written to introduce the strengths and weaknesses of EPAs. After a brief historical overview, the reason why EPAs are a bridge between a competency framework and daily clinical practice is explained. While competencies are qualities of individuals, EPAs are units of work. The two can be seen as two dimensions of a matrix, showing that almost all activities in health care are based on multiple competencies, such as communication skill, collaboration, professional behavior, content knowledge. Next, entrustment decision-making as a form of assessment is created and a framework of levels of supervision is presented. Entrustment decisions focus on the level of supervision a student requires for a specific activity, divided into five levels (1: allowed to observe; 2; allowed to perform under direct supervision; 3: allowed to perform under indirect supervision; 4: allowed to perform the activity unsupervised; 5: allowed to supervise the activity performed by more junior learners). For readers interested in applying the concept to practice, a stepwise approach to the curriculum development is proposed. The paper concludes with an overview of the state-of-the-art of working with EPAs across disciplines, professions and countries.

Organizational Dynamics Around Sexual Harassment Interventions and Occurrences in Clinical Training Healthcare Environments

2021 ◽  
pp. 300-319
Author(s):  
Darrell Norman Burrell ◽  
Anton Shufutinsky ◽  
Terrence D. Duncan ◽  
Delores Springs ◽  
Quatavia McLester ◽  
...  
Keyword(s):  
Sexual Harassment ◽  
Clinical Training ◽  
Medical Training ◽  
Medical Center ◽  
Sexual Misconduct ◽  
Health Science ◽  
Cultural Issues ◽  
Training Environment ◽  
Organizational Safety ◽  
Staff Members

The clinical training of healthcare professionals and the delivery of safe healthcare is reliant on a vigorous organizational safety culture, one where the workplace and medical training environment is free of hostility and harassment. Sexual harassment and sexual misconduct are significant problems for women in healthcare. For all staff members, it is imperative that the hospital has clear, solid policies and, even more importantly, procedures and communication of those procedures for reporting problems concerning harassment. This research inquiry uses case study action research in the context of an OD intervention in school of health science and medical center that provides clinical and medical training and community patient care. The organization has significant organizational cultural issues around harassment. Results indicate the need for more proactive strategies around leadership and organizational cultural change that can apply to medical schools, schools of health science, and medical centers.

scholarly journals Identifying Entrustable Professional Activities in Internal Medicine Training

2013 ◽  
Vol 5 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Karen E. Hauer ◽  
Jeffrey Kohlwes ◽  
Patricia Cornett ◽  
Harry Hollander ◽  
Olle ten Cate ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Content Validity ◽  
Medical Training ◽  
Entrustable Professional Activities ◽  
Internal Medicine Training ◽  
Professional Activities ◽  
Delphi Approach ◽  
Validity Indices ◽  
Competency Based ◽  
Competency Based Assessment

Abstract Background Entrustable professional activities (EPAs) can form the foundation of competency-based assessment in medical training, focused on performance of discipline-specific core clinical activities. Objective To identify EPAs for the Internal Medicine (IM) Educational Milestones to operationalize competency-based assessment of residents using EPAs. Methods We used a modified Delphi approach to conduct a 2-step cross-sectional survey of IM educators at a 3-hospital IM residency program; residents also completed a survey. Participants rated the importance and appropriate year of training to reach competence for 30 proposed IM EPAs. Content validity indices identified essential EPAs. We conducted independent sample t tests to determine IM educator-resident agreement and calculated effect sizes. Finally, we determined the effect of different physician roles on ratings. Results Thirty-six IM educators participated; 22 completed both surveys. Twelve residents participated. Seventeen EPAs had a content validity index of 100%; 10 additional EPAs exceeded 80%. Educators and residents rated the importance of 27 of 30 EPAs similarly. Residents felt that 10 EPAs could be met at least 1 year earlier than educators had specified. Conclusions Internal medicine educators had a stable opinion of EPAs developed through this study, and residents generally agreed. Using this approach, programs could identify EPAs for resident evaluation, building on the initial list created via our study.

scholarly journals Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

2021 ◽  
pp. 153473462110118
Author(s):  
Anna Eleftheriou ◽  
Aikaterini Rokou ◽  
Christos Argyriou ◽  
Nikolaos Papanas ◽  
George S. Georgiadis
Keyword(s):  
Medical Education ◽  
Clinical Training ◽  
Medical Training ◽  
Medical Schools ◽  
Web Based ◽  
Clinical Exposure ◽  
Virtual Teaching ◽  
Based Medicine ◽  
The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

Development of Entrustable Professional Activities for Training of Hospice and Palliative Care Pharmacists (SCI961)

2021 ◽  
Vol 61 (3) ◽  
pp. 702-703
Author(s):  
Kashelle Lockman ◽  
Maria Lowry ◽  
Sandra Discala ◽  
Tanya Uritsky ◽  
Amanda Lovell ◽  
...  
Keyword(s):  
Palliative Care ◽  
Entrustable Professional Activities ◽  
Professional Activities ◽  
Hospice And Palliative Care

scholarly journals The Fellow’s Perspective: The Impact of the COVID-19 Pandemic on Fellowship Training and Job Appointment

2021 ◽  
pp. 000313482110241
Author(s):  
Adam Truong ◽  
Farin Amersi ◽  
Van Chau ◽  
Taryne Imai
Keyword(s):  
Clinical Training ◽  
Medical Center ◽  
Fellowship Training ◽  
Surgical Specialty ◽  
Job Interview ◽  
Educational Structure ◽  
Global Pandemic ◽  
Procedural Volume ◽  
Interview Format ◽  
The Impact

Background Fellows have been uniquely affected by the widespread changes in educational structure, mandatory limitations in elective procedural volume, and hiring freezes during the COVID-19 global pandemic. Study Design A voluntary and anonymous survey was distributed to all Graduate Medical Education fellows at a tertiary medical center querying perspectives on clinical and didactic training and job placement. Results A total of 47 of 121 fellows (39%) completed the survey. The majority were in a medical (43%) or surgical specialty (34%) followed by critical care (13%) and procedure-based (11%) fellowships. Approximately 59% of surveyed fellows felt their programs were providing a virtual curriculum that would train them just as well as the in-person curriculum. Twenty-eight (60%) fellows were in their final or only year of training. Of the 25 fellows who were seeking employment, 52% have experienced difficulty in finding a job due to hiring freezes and 40% have encountered challenges with job interview cancellations and changes to virtual interview formats. Conclusion Almost half of surveyed fellows reported an educational deterioration due to COVID-19 and graduating fellows seeking employment felt hindered by both the virtual interview format and widespread hiring freeze. Fellows are both unique and vulnerable as they balance the solidification of clinical training with securing employment during these tumultuous and unprecedented times.

scholarly journals Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wafa Aftab ◽  
Mishal Khan ◽  
Sonia Rego ◽  
Nishant Chavan ◽  
Afifah Rahman-Shepherd ◽  
...  
Keyword(s):  
Medical Education ◽  
Health Systems ◽  
Clinical Training ◽  
Medical Training ◽  
Grey Literature ◽  
Analytical Framework ◽  
Online News ◽  
Country Comparison ◽  
Education Delivery ◽  
The Right

Abstract Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.

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