The Implementation of Entrustable Professional Activities in Postgraduate Medical Education in the Netherlands: Rationale, Process, and Current Status

Introduction: E-portfolio may facilitate the entrustment process from supervisors to residents in postgraduate medical education. The present study was aimed at identifying necessary features of an e-portfolio application and to conduct pilot study in a teaching hospital. Methods: Six programs participated. Eight interviews with education directors and six focus group discussions with residents and supervisors were completed for the needs analysis stage. The application was developed based on the thematic analysis of the needs analysis stage. The mobile-app e-portfolio pilot was conducted for four weeks and a modified version of the System Usability Scale (SUS) was distributed to participants following the pilot program. Results: Key features of the e-portfolio were identified. A total of 45 supervisors and 66 residents participated in the pilot study. The residents utilised the application according to the clinical activities and supervision level, and the information was fed to the supervisors as per the application design. Challenges during the pilot study in terms of feedback provision and residents’ workload which influence the e-portfolio use for entrustment decisions are discussed. Conclusion: Current e-portfolio features were created for supervision and are potential to facilitate the entrustment process in Entrustable Professional Activities (EPA) implementation. The pilot study highlighted challenges of the implementation which should be considered for future improvement.

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Medical Education and Training Within Congenital Cardiology: Current Global Status and Future Directions in A Post COVID-19 World

Cardiology in the Young ◽

10.1017/s1047951121001645 ◽

2021 ◽

pp. 1-40

Author(s):

Colin J. McMahon ◽

Justin T. Tretter ◽

Andrew N. Redington ◽

Frances Bu’Lock ◽

Liesl Zühlke ◽

...

Keyword(s):

Medical Education ◽

Vital Role ◽

Current Status ◽

Technology Enhanced Learning ◽

Middle Income ◽

Critical Reasoning ◽

Professional Activities ◽

Competency Frameworks ◽

Medical Education And Training ◽

Global Status

Abstract Despite enormous strides in our field with respect to patient care, there has been surprisingly limited dialogue on how to train and educate the next generation of congenital cardiologists. This paper reviews the current status of training and evolving developments in medical education pertinent to congenital cardiology. The adoption of competency-based medical education has been lauded as a robust framework for contemporary medical education over the last two decades. However, inconsistencies in frameworks across different jurisdictions remain, and bridging gaps between competency frameworks and clinical practice has proved challenging. Entrustable professional activities have been proposed as a solution but integration of such activities into busy clinical cardiology practices will present its own challenges. Consequently, this pivot toward a more structured approach to medical education necessitates the widespread availability of appropriately trained medical educationalists; a development that will better inform curriculum development, instructional design, and assessment. Differentiation between superficial and deep learning, the vital role of rich formative feedback and coaching, should guide our trainees to become self-regulated learners, capable of critical reasoning yet retaining an awareness of uncertainty and ambiguity. Furthermore, disruptive innovations such as ‘technology enhanced learning’ may be leveraged to improve education, especially for trainees from low- and middle-income countries. Each of these initiatives will require resources, widespread advocacy and raised awareness, and publication of supporting data, and so it is especially gratifying that Cardiology in The Young has fostered a progressive approach, agreeing to publish one or two articles in each journal issue in this domain.

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Entrustable Professional Activities in Hematopathology Pathology Fellowship Training: Consensus Design and Proposal

Academic Pathology ◽

10.1177/2374289521990823 ◽

2021 ◽

Vol 8 ◽

pp. 237428952199082

Author(s):

Kristie White ◽

Julianne Qualtieri ◽

Elizabeth L. Courville ◽

Rose C. Beck ◽

Bachir Alobeid ◽

...

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Fellowship Training ◽

Entrustable Professional Activities ◽

Guidance Document ◽

Accreditation Council ◽

Graduate Medical ◽

Professional Activities ◽

Constructive Feedback ◽

Delphi Approach

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.

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Entrustable Professional Activities for Pathology

Academic Pathology ◽

10.1177/2374289517714283 ◽

2017 ◽

Vol 4 ◽

pp. 237428951771428 ◽

Cited By ~ 12

Author(s):

Cindy B. McCloskey ◽

Ronald E. Domen ◽

Richard M. Conran ◽

Robert D. Hoffman ◽

Miriam D. Post ◽

...

Keyword(s):

Medical Education ◽

Residency Training ◽

Graduate Medical Education ◽

Clinical Pathology ◽

Entrustable Professional Activities ◽

Professional Activity ◽

Entrustable Professional Activity ◽

Accreditation Council ◽

Graduate Medical ◽

Professional Activities

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.

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A search for entrustable professional activities for the 1st year pathology postgraduate trainees

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_51_17 ◽

2018 ◽

Vol 10 (01) ◽

pp. 026-030 ◽

Cited By ~ 3

Author(s):

Pooja Sharma ◽

Nadeem Tanveer ◽

Aditi Goyal

Keyword(s):

Medical Education ◽

Training Program ◽

Paradigm Shift ◽

Entrustable Professional Activities ◽

Average Score ◽

Professional Activities ◽

The Past ◽

Cumulative Score ◽

Competency Based ◽

The Right

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.

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