scholarly journals Feasibility of an Entrustable Professional Activity for Pathology Resident Frozen Section Training

2021 ◽  
Vol 8 ◽  
pp. 237428952110417
Author(s):  
Bronwyn H. Bryant
Keyword(s):  
Medical Education ◽  
Frozen Section ◽  
Resident Training ◽  
Entrustable Professional Activities ◽  
Professional Activity ◽  
Clinical Competency ◽  
Professional Activities ◽  
Competency Based ◽  
The University ◽  
Clinical Competency Committee

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.

scholarly journals Entrustable Professional Activities for Pathology

2017 ◽  
Vol 4 ◽  
pp. 237428951771428 ◽  
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.

scholarly journals Use of Milestones and Development of Entrustable Professional Activities in 2 Hematology/Oncology Training Programs

2015 ◽  
Vol 7 (1) ◽  
pp. 101-104 ◽  
Author(s):  
Nathan M. Shumway ◽  
Jennifer J. Dacus ◽  
Kate I. Lathrop ◽  
Elizabeth P. Hernandez ◽  
Maria Miller ◽  
...  
Keyword(s):  
Program Directors ◽  
Assessment Tools ◽  
Entrustable Professional Activities ◽  
Clinical Competency ◽  
Clinical Faculty ◽  
Continuity Clinic ◽  
Professional Activities ◽  
Starting Point ◽  
Next Accreditation System ◽  
Clinical Competency Committee

Abstract Background The Next Accreditation System (NAS) increases the focus on educational outcomes and meaningful evaluation of learners. This requires that key clinical faculty develop new assessment formats such as entrustable professional activities (EPAs). Objectives To build and develop milestone-based assessment tools supporting 5 EPAs for a hematology/oncology fellow continuity clinic, and to educate key clinical faculty regarding the Clinical Competency Committee (CCC) and the NAS. Methods Program directors from 2 hematology/oncology fellowship programs developed 5 EPAs for continuity clinic evaluation supported by milestone-based assessment. The program directors met to create a unified CCC charter. Key clinical faculty helped to develop a milestone-based evaluation of fellow continuity clinic through creation of 5 hematology/oncology-specific EPAs. Formal entrustment regarding EPAs was deliberated by the CCC. Results A total of 18 fellows were evaluated. Clinical Competency Committee deliberation at each institution took approximately 10 minutes per fellow for discussion and decision regarding entrustment for all 5 EPAs supporting continuity clinic. One-third of postgraduate year (PGY)–4s, 50% of PGY-5s, and 100% of PGY-6s were deemed competent in all 5 EPAs by the CCC. Conclusions All hematology/oncology trainees in San Antonio were evaluated using milestone-based assessment for continuity clinic, and entrustment decisions regarding 5 EPAs were made by the CCC. This project may provide other programs with a sound basis for adoption and further development of the next generation of evaluation tools at their institutions. Entrustable professional activities that are rotation specific should be used as a starting point for linking to the competencies, subcompetencies, and the reporting milestones.

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

2018 ◽  
Vol 10 (01) ◽  
pp. 026-030 ◽  
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.

scholarly journals An Entrustable Professional Activity Addressing Racism and Pediatric Health Inequities

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Ndidi I. Unaka ◽  
Ariel Winn ◽  
Adiaha Spinks-Franklin ◽  
Patricia Poitevien ◽  
Franklin Trimm ◽  
...  
Keyword(s):  
Medical Education ◽  
Health Care Systems ◽  
Health Inequities ◽  
Professional Activity ◽  
Competency Based Medical Education ◽  
Pediatric Health ◽  
Professional Activities ◽  
Care Systems ◽  
Competency Based ◽  
Pediatric Populations

Racism and discrimination are the root of many pediatric health inequities and are well described in the literature. Despite the pervasiveness of pediatric health inequities, we have failed to adequately educate and prepare general pediatricians and pediatric subspecialists to address them. Deficiencies within education across the entire continuum and in our health care systems as a whole contribute to health inequities in unacceptable ways. To address these deficiencies, the field of pediatrics, along with other specialties, has been on a journey toward a more competency-based approach to education and assessment, and the framework created for the future is built on entrustable professional activities (EPAs). Competency-based medical education is one approach to addressing the deficiencies within graduate medical education and across the continuum by allowing educators to focus on the desired equitable patient outcomes and then develop an approach to teaching and assessing the tasks, knowledge, skills, and attitudes needed to achieve the goal of optimal, equitable patient care. To that end, we describe the development and content of a revised EPA entitled: Use of Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations. We also highlight the ways in which this EPA can be used to inform curricula, assessments, professional development, organizational systems, and culture change.

scholarly journals Trusting our trainees: competency-based training of cardiologists using Entrustable Professional Activities (EPA)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Beeri ◽  
F.C Tanner ◽  
O Ten Cate ◽  
M Ros ◽  
P Kirchhof
Keyword(s):  
Medical Education ◽  
Core Curriculum ◽  
Clinical Care ◽  
Quality Care ◽  
Entrustable Professional Activities ◽  
Core Knowledge ◽  
Specific Training ◽  
Professional Activities ◽  
Competency Based ◽  
Education Conference

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

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 Surgery Goes EPA (Entrusted Professional Activity) – How a Strikingly Easy to use App Revolutionizes Assessments of Clinical Skills in Surgical Training

2021 ◽  
Author(s):  
Nadine Diwersi ◽  
Jörn-Markus Gass ◽  
Henning Fischer ◽  
Jürg Metzger ◽  
Matthias Knobe ◽  
...  
Keyword(s):  
Medical Education ◽  
Clinical Skills ◽  
Total Duration ◽  
Professional Activity ◽  
User Friendliness ◽  
Aggregated Data ◽  
Professional Activities ◽  
Competency Based ◽  
User Friendly

Abstract ObjectiveEntrusted Professional Activities (EPAs) are increasingly being used in competency-based medical education approaches. A general lack of time in clinical settings, however, prevents supervisors from providing their trainees with adequate feedback. With a willingness for more administrative tasks being low in both trainees and educators, the authors developed a radical user-friendly mobile application based on the EPA concept called “Surg-prEPAred”.DesignSurg-prEPAred is designed to collect micro-assessment data for building competency profiles for surgical residents according to their curriculum. The goal of Surg-prEPAred is to facilitate the performance and documentation of workplace-based assessments. Through aggregated data the app generates a personalized competency profile for every trainee. During a pilot run of 4 months, followed by ongoing usage of the application with a total duration of 9 months (August 2019 to April 2020), 32 residents and 33 consultants made daily use of the application as a rating tool. Every rating included knowledge, skills and professional attitudes of the trainees. Before the initiation of the App and after the 9-month trial period trainees and supervisors where both sent questionnaires to evaluate the user friendliness and effectiveness of the App. Results510 App based assessments were generated. Out of 40 pre-defined EPAs, 36 were assessed. 15 trainees and 16 supervisors returned the questionnaires and stated the surg-prEPAred App as very valuable, effective and feasible to evaluate trainees in a clinical setting providing residents with an individual competence portfolio to receive precision medical education. ConclusionsThe authors expectation is that the Surg-prEPAred App will contribute to an improvement of quality of medical education and thus to the quality of patient care and safety. In the future the goal is to have the App become an integral part of the official Swiss surgical curriculum accepted by the Swiss professional surgical society.

scholarly journals Using mobile technology in assessment of entrustable professional activities in undergraduate medical education

2020 ◽  
Author(s):  
Norah Duggan ◽  
Vernon R. Curran ◽  
Nicholas A. Fairbridge ◽  
Diana Deacon ◽  
Heidi Coombs ◽  
...  
Keyword(s):  
Medical Education ◽  
Mobile Technology ◽  
Ease Of Use ◽  
Entrustable Professional Activities ◽  
Professional Activity ◽  
Preliminary Evaluation ◽  
Entrustable Professional Activity ◽  
Professional Activities ◽  
Core Clerkship ◽  
Mobile Assessment

Abstract Background The adoption of competency-based medical education requires objective assessments of a learner’s capability to carry out clinical tasks within workplace-based learning settings. This study involved an evaluation of the use of mobile technology to record entrustable professional activity assessments in an undergraduate clerkship curriculum. Approach A paper-based form was adapted to a mobile platform called eClinic Card. Students documented workplace-based assessments throughout core clerkship and preceptors confirmed accuracy via mobile phones. Assessment scores for the 2017–2018 academic year were collated and analyzed for all core rotations, and preceptors and students were surveyed regarding the mobile assessment experience. Evaluation The mobile system enabled 80 students and 624 preceptors to document 6850 assessment submissions across 47 clinical sites over a 48-week core clerkship curriculum. Students’ scores demonstrated progressive improvement across all entrustable professional activities with stage-appropriate levels of independence reported by end of core clerkship. Preceptors and students were satisfied with ease of use and dependability of the mobile assessment platform; however, students felt quality of formative coaching feedback could be improved. Reflection Our preliminary evaluation suggests the use of mobile technology to assess entrustable professional activity achievement across a core clerkship curriculum is a feasible and acceptable modality for workplace-based assessment. The use of mobile technology supported a programmatic assessment approach. However, meaningful coaching feedback, as well as faculty development and support, emerged as key factors influencing successful adoption and usage of entrustable professional activities within an undergraduate medical curriculum.

scholarly journals An analysis of core EPAs reveals a gap between curricular expectations and medical school graduates’ self-perceived level of competence

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adrian Marty ◽  
Sonia Frick ◽  
Heidi Bruderer Enzler ◽  
Sabine Zundel
Keyword(s):  
Medical Education ◽  
Online Survey ◽  
Management Plan ◽  
Practical Skills ◽  
Professional Activities ◽  
Emergency Situations ◽  
New Curriculum ◽  
Competency Based ◽  
University Of Zurich ◽  
The University

Abstract Background Entrustable Professional Activities (EPAs) are being implemented worldwide as a means to promote competency-based medical education. In Switzerland, the new EPA-based curriculum for undergraduate medical education will be implemented in 2021. The aim of our study was to analyze the perceived, self-reported competence of graduates in 2019. The data represent a pre-implementation baseline and will provide guidance for curriculum developers. Methods Two hundred eighty-one graduates of the Master of Human Medicine program of the University of Zurich who had passed the Federal Licensing Exam in September 2019 were invited to complete an online survey. They were asked to rate their needed level of supervision (“observe only”, “direct, proactive supervision”, “indirect, reactive supervision”) for 46 selected EPAs. We compared the perceived competence with the expected competence of the new curriculum. Results The response rate was 54%. The need for supervision expressed by graduates varied considerably by EPA. The proportion of graduates rating themselves at expected level was high for “history taking”, “physical examination” “and documentation”; medium for “prioritizing differential diagnoses”, “interpreting results” and “developing and communicating a management plan”; low for “practical skills”; and very low for EPAs related to “urgent and emergency care”. Conclusions Currently, there are significant gaps between the expectations of curriculum developers and the perceived competences of students. This is most obvious for practical skills and emergency situations. The new curriculum will either need to fill this gap or expectations might need to be revised.

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