Development of a List of Competencies and Entrustable Professional Activities for Resident Physicians During Death Pronouncement: A Modified Delphi Study

2021 ◽  
Author(s):  
Takaomi Kessoku ◽  
Yu Uneno ◽  
Yuka Urushibara-Miyach ◽  
Kiyofumi Oya ◽  
Akihiko Kusakabe ◽  
...  
Keyword(s):  
Delphi Study ◽  
Evaluation Method ◽  
Entrustable Professional Activities ◽  
Snowball Sampling ◽  
Professional Activities ◽  
Modified Delphi ◽  
Resident Physicians ◽  
External Evaluators ◽  
Item List ◽  
General Wards

Abstract Purpose: Appropriate delivery of death pronouncements potentially affects bereaved families’ wellbeing positively. Younger physicians need to learn death pronouncement skills; currently, the competencies and entrustable professional activities (EPAs) in death pronouncement practice have not been clarified.Therefore, this study aimed to develop a list of competencies and EPAs necessary for death pronouncement practice, which resident physicians need to acquire by the end of their residency training (postgraduate year 2).Methods: An anonymous modified Delphi study was conducted with a panel of 31 experts. The experts were invited online from general wards in hospitals with resident physicians across Japan to participate in the study using the purposive and snowball sampling method. A non-anonymous web conference was held with three additional external evaluators to finalize the item list. The consensus criterion was defined as a mean response of at least 4 points on a 5-point Likert scale for each competency and EPA item and a rating of 4 or 5 points by at least 80% of the participants.Results: Consensus was achieved, with consistently high levels of agreement across panel members, on 11 competencies and 9 EPA items. Additionally, a correspondence matrix table between competencies and EPAs was developed.Conclusions: This study clarified the standardized educational outcomes for knowledge, skills, and attitudes in death pronouncement practice and the level of physicians who can perform this practice independently, serving as a blueprint to aid the development of an educational model and evaluation method for clinical educational institutions and developers of medical school curriculums.

scholarly journals Development of entrustable professional activities for residents rotating nephrology department in a Japanese university hospital: a Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047923
Author(s):  
Akihito Tanaka ◽  
Takeshi Kondo ◽  
Yuka Urushibara-Miyachi ◽  
Shoichi Maruyama ◽  
Hiroshi Nishigori
Keyword(s):  
Delphi Method ◽  
Delphi Study ◽  
Evaluation Criteria ◽  
University Hospital ◽  
Entrustable Professional Activities ◽  
Affiliate Hospital ◽  
Japanese University ◽  
Professional Activities ◽  
Modified Delphi ◽  
Initial List

ObjectivesTraining strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions.DesignPurposive design and a modified Delphi method to build consensus.SettingThe department of nephrology in a university hospital in Aichi Prefecture, Japan.ParticipantsBased on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD <1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated.ResultsAn initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure.ConclusionsThe concept of EPAs enabled us to develop goals and evaluation criteria for residents’ training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.

scholarly journals Development of entrustable professional activities for paediatric intensive care fellows: A national modified Delphi study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248565
Author(s):  
Marije P. Hennus ◽  
Anneliese Nusmeier ◽  
Gwen G. M. van Heesch ◽  
Maaike A. Riedijk ◽  
Nikki J. Schoenmaker ◽  
...  
Keyword(s):  
Delphi Study ◽  
Task Force ◽  
Assessment System ◽  
Entrustable Professional Activities ◽  
Specialty Training ◽  
Professional Activities ◽  
Modified Delphi ◽  
Delphi Round ◽  
Learner Assessment ◽  
High Degree

Entrustable professional activities (EPAs), as a focus of learner assessment, are supported by validity evidence. An EPA is a unit of professional practice requiring proficiency in multiple competencies simultaneously, that can be entrusted to a sufficiently competent learner. Taken collectively, a set of EPAs define and inform the curriculum of a specialty training. The goal of this study was to develop a set of EPAs for Dutch PICU fellows. A multistage methodology was employed incorporating sequential input from task force members, a medical education expert, PICU fellowship program directors, and PICU physicians and fellows via a modified three-round Delphi study. In the first modified Delphi round, experts rated indispensability and clarity of preliminary EPAs. In the subsequent rounds, aggregated scores for each EPA and group comments were provided. In round two, respondents rated indispensability and clarity of revised EPAs. Round three was used to gain explicit confirmation of suitability to implement these EPAs. Based on median ratings and content validity index (CVI) analysis for indispensability in the first two rounds, all nine preliminary EPAs covered activities that were deemed essential to the clinical practice of PICU physicians. Based on median ratings and CVI analysis for clarity however, four EPAs needed revision. With an agreement percentage of 93–100% for all individual EPAs as well as the set as a whole, a high degree of consensus among experts was reached in the third round. The resulting nine PICU EPAs provide a succinct overview of the core tasks of Dutch PICU physicians. These EPAs were created as an essential first step towards developing an assessment system for PICU fellows, grounded in core professional activities. The robust methodology used, may have broad applicability for other (sub)specialty training programs aiming to develop specialty specific EPAs.

scholarly journals Entrustable Professional Activities for Community Medicine: Integrating Medical Undergraduate Courses and Primary Health Care

2020 ◽  
Author(s):  
Aixa Hafsha
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Delphi Study ◽  
Community Medicine ◽  
Entrustable Professional Activities ◽  
Management Tool ◽  
Curriculum Management ◽  
Professional Activities ◽  
Primary Health ◽  
Medical Undergraduate

Community medicine represents a far-reaching field for the advance of health care, with impact on people’s quality of life and health needs. Health promotion, disease prevention, recovery and rehabilitation have to be incorporated satisfactorily into medical education. The search for a pedagogical tool to fulfill the medical curriculum through actions of community medicine care led us to outline 11 Entrustable Professional Activities (EPAs) for community medicine. The study was carried out at a public Medical School in Brazil that has a Competency-Based Curriculum (CBC). Fifteen teachers with expertise in community medicine analyzed the resulting EPAs. The EPAs were distributed in three domain areas: care needs of the individual, family and community in Primary Health Care. The teachers answered a total of 13 open questions in a two-round Delphi study. The discourses were submitted to thematic content analysis. Three discourse categories were found about the outlined EPAs: curriculum management and social needs, curriculum management and service integration, and curriculum management and actors. The understanding of the EPAs as a curriculum management tool was relevant, as well as their interface with health care and learning development. The consulted teachers agreed with the designed EPAs and that they are adequate for the first two years of the studied medical course in their Brazilian context. Therefore, it was concluded that the community medicine EPAs are appropriate for the new medical profile, especially in countries with social exclusion, and are a very good tool to promote integrality of care and humanism. This study can facilitate the implementation of a CBC in community medicine and assist in overcoming its challenges through the adoption of the designed EPAs.

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