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Core EPA

Ariel S Winn, Carolyn H Marcus, Theodore C Sectish, Kathryn Williams, Christopher P Landrigan
OBJECTIVES: The Association of American Medical Colleges published a list of entrustable professional activities (EPAs) that graduating medical students should be able to perform on day 1 of residency without direct supervision. We sought to explore the perceptions of residents and pediatric hospitalists about the level of supervision new interns need in conducting these EPAs. METHODS: An electronic survey was sent to pediatric hospitalists who supervise interns in a large pediatric residency program in which they were asked to rate the amount of supervision they perceive new interns need when performing 11 EPAs...
March 13, 2018: Hospital Pediatrics
Judith Brenner, Jeffrey Bird, Samara B Ginzburg, Thomas Kwiatkowski, Vincent Papasodero, William Rennie, Elisabeth Schlegel, Olle Ten Cate, Joanne M Willey
BACKGROUND: Two dominant themes face medical education: developing integrated curricula and improving the undergraduate medical education (UME) to graduate medical education (GME) transition. An innovative solution to both of these challenges at the Zucker School of Medicine has been the application of the cognitive apprenticeship framework in requiring emergency medical technician (EMT) certification during the first course in medical school as the core on which to build an integrated curriculum and provide entrustable clinical skills...
March 8, 2018: Medical Teacher
Olle Ten Cate, Lysanne Graafmans, Indra Posthumus, Lisanne Welink, Marijke van Dijk
AIM: As reports of the application of entrustable professional activities (EPAs) increase, not only for postgraduate but also for undergraduate medical education, there is a need for descriptions of what a UME curriculum with EPAs could look like. We provide such a description based on the experiences at University Medical Center Utrecht, the Netherlands, which can be used as an example by other curriculum developers. METHODS: In a three-year process, the UMC Utrecht Curriculum Committee developed a clinical workplace curriculum with an EPA structure, taking into account examples, such as the US Core EPAs for Entering Residency, and recommendations to integrate and increase the length of clerkships...
February 22, 2018: Medical Teacher
Bo Gao, Li Gao, Dongyu Xu, Yang Zhou, Jin Lu
The mobility and transfer of trace metals in sediments are vital to understanding trace metals environmental behavior in water environment. However, as a predominant aquatic carcinogen, an effective method for assessing the release and deposition for Cr at the sediment-water interface (SWI) is still not clearly understood. Here we established a comprehensive methodology to evaluate the release risk of Cr at the SWI combining regional geochemical baseline (RGB) and diffusive gradients in thin films (DGT). Sediment cores and water samples were collected in the two tributaries and mainstream of the Three Gorges Reservoir, which is the world's largest man-made hydroelectric station...
February 10, 2018: Science of the Total Environment
Samuel C R Sherratt, R Preston Mason
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) differentially influence lipid oxidation, signal transduction, fluidity, and cholesterol domain formation, potentially due in part to distinct membrane interactions. We used small angle x-ray diffraction to evaluate the EPA and DHA effects on membrane structure. Membrane vesicles composed of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) and cholesterol (C) (0.3C:POPC mole ratio) were prepared and treated with vehicle, EPA, or DHA (1:10 mole ratio to POPC)...
January 17, 2018: Chemistry and Physics of Lipids
Holli Horak, Robert Englander, Diana Barratt, Jeff Kraakevik, Madhu Soni, Ezgi Tiryaki
Medical education is currently undergoing a paradigm shift from process-based to competency-based education, focused on measuring the desired competence of a physician. In an attempt to improve the assessment framework used for medical education, the concept of entrustable professional activities (EPAs) has gained traction. EPAs are defined as professional activities that can be entrusted to an individual in a clinical context. The Association of American Medical Colleges (AAMC) defined a set of 13 such EPAs to define the core of what all students should be able to do on day 1 of residency, regardless of specialty choice...
February 13, 2018: Neurology
W E Sjoukje van den Broek, Marjo Wijnen-Meijer, Olle Ten Cate, Marijke van Dijk
Objectives: This study adds to the ongoing discussion on how to ease the transition from undergraduate medical training to postgraduate training. In the Netherlands there is no central matching system for admission to residency. Medical school graduates just apply for a position in an open job market. Many choose to acquire general or specialty-specific clinical experiences after the medical degree before residency, to further explore career opportunities and to increase their chances to get into their preferred specialty...
2017: GMS Journal for Medical Education
Yordkhuan Tachapermpon, Sopida Thavornpradit, Adisri Charoenpanich, Jitnapa Sirirak, Kevin Burgess, Nantanit Wanichacheva
A near-infrared (NIR) fluorescent sensor 1 composed of an aza-boron-dipyrromethene (aza-BODIPY) core covalently bound to two di-2-picolylamine moieties was conceived for Cu2+ detection in aqueous solutions. Spectroscopic properties and binding abilities with several metal ions were investigated in phosphate buffered saline (pH 7.4): acetonitrile (95 : 5 v/v) with Triton X-100 via fluorometric titrations. The fluorescence of sensor 1 was quenched selectively by cupric ions in the presence of alkali- and transition-metal-ions...
November 28, 2017: Dalton Transactions: An International Journal of Inorganic Chemistry
Brent Moloughney, Kieran Moore, Damon Dagnone, David Strong
Background: Entrustable Professional Activities (EPAs) have emerged to bridge the gap between the learning of individual competencies and competence in real world practice. EPAs capture the critical core work of a discipline integrating competencies from multiple domains. This report describes the development of a set of EPAs for specialty training in Public Health and Preventive Medicine (PHPM) in Canada. Methods: The PHPM EPAs were developed using multiple existing sources...
June 2017: Canadian Medical Education Journal
Pamela M Basehore, Luke H Mortensen, Emmanuel Katsaros, Machelle Linsenmeyer, Elizabeth K McClain, Patricia S Sexton, Nicole Wadsworth
Entrustable professional activities (EPAs) are measurable units of observable professional practice that can be entrusted to an unsupervised trainee. They were first introduced as a method of operationalizing competency-based medical education in graduate medical education. The American Association of Medical Colleges subsequently used EPAs to establish the core skills that medical students must be able to perform before they enter residency training. A recently published guide provides descriptions, guidelines, and rationale for implementing and assessing the core EPAs from an osteopathic approach...
November 1, 2017: Journal of the American Osteopathic Association
R Ellen Pearlman, Melissa Pawelczak, Andrew C Yacht, Salaahuddin Akbar, Gino A Farina
BACKGROUND : The Association of American Medical Colleges describes 13 core entrustable professional activities (EPAs) that every graduating medical student should be expected to perform proficiently on day 1 of residency, regardless of chosen specialty. Studies have shown wide variability in program director (PD) confidence in interns' abilities to perform these core EPAs. Little is known regarding comparison of United States Medical Licensing Examination (USMLE) scores with proficiency in EPAs...
October 2017: Journal of Graduate Medical Education
Anne G Pereira, Majka Woods, Andrew P J Olson, Suzanne van den Hoogenhof, Briar L Duffy, Robert Englander
In the United States, the medical education community has begun a shift from the Flexnerian time-based model to a competency-based medical education model. The graduate medical education (GME) community is substantially farther along in this transition than is the undergraduate medical education (UME) community.GME has largely adopted the use of competencies and their attendant milestones and increasingly is employing the framework of entrustable professional activities (EPAs) to assess trainee competence. The UME community faces several challenges to successfully navigating a similar transition...
October 3, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Sara B Fazio, Cynthia H Ledford, Paul B Aronowitz, Shobhina G Chheda, John H Choe, Stephanie A Call, Scott D Gitlin, Marty Muntz, L James Nixon, Anne G Pereira, John W Ragsdale, Emily A Stewart, Karen E Hauer
As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Núria Bargalló, Rosa Gilabert, Edwin-Saúl Romero-Mamani, Montserrat Cofán, Philip C Calder, Montserrat Fitó, Dolores Corella, Jordi Salas-Salvadó, Miguel Ruiz-Canela, Ramon Estruch, Emilio Ros, Aleix Sala-Vila
Supplemental marine omega-3 eicosapentaenoic acid (EPA) has an anti-atherosclerotic effect. Clinical research on EPA supplied by the regular diet and atherosclerosis is scarce. In the framework of the PREvención con DIeta MEDiterránea (PREDIMED) trial, we conducted a cross-sectional study in 161 older individuals at high vascular risk grouped into different stages of carotid atherosclerosis severity, including those without ultrasound-detected atheroma plaque (n = 38), with plaques <2.0 mm thick (n = 65), and with plaques ≥2...
September 20, 2017: Nutrients
Edward Krupat
The Core Entrustable Professional Activities for Entering Residency (Core EPAs) have taken a strong hold on undergraduate medical education (UME). This Perspective questions their value added and considers the utility of the Core EPAs along two separate dimensions: (1) the ways they change the content and focus of the goals of UME; and (2) the extent to which entrustable professional activity (EPA)-based assessment conforms to basic principles of measurement theory as practiced in the social sciences. Concerning content and focus, the author asks whether the 13 Core EPAs frame UME too narrowly, putting competencies into the background and overlooking certain aspirational, but important and measurable, objectives of UME...
August 29, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Rachel D Havyer, Suzanne M Norby, Andrea N Leep Hunderfund, Stephanie R Starr, Tara R Lang, Alexandra P Wolanskyj, Darcy A Reed
BACKGROUND: The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians' abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students' competence in SHCD...
August 25, 2017: BMC Medical Education
Aaron Ross Flakemore, Bunmi Sherifat Malau-Aduli, Peter David Nichols, Aduli Enoch Othniel Malau-Aduli
BACKGROUND: Omega-3 long-chain (≥C20) polyunsaturated fatty acids (ω3 LC-PUFA) confer important attributes to health-conscious meat consumers due to the significant role they play in brain development, prevention of coronary heart disease, obesity and hypertension. In this study, the ω3 LC-PUFA content of raw and cooked Longissimus thoracis et lumborum (LTL) muscle from genetically divergent Australian prime lambs supplemented with dietary degummed crude canola oil (DCCO) was evaluated...
2017: Journal of Animal Science and Technology
Lindy H Landzaat, Michael D Barnett, Gary T Buckholz, Jillian L Gustin, Jennifer M Hwang, Stacie K Levine, Tomasz R Okon, Steven M Radwany, Holly B Yang, John Encandela, Laura J Morrison
CONTEXT: Entrustable Professional Activities (EPAs) represent the key physician tasks of a specialty. Once a trainee demonstrates competence in an activity, they can then be "entrusted" to practice without supervision. A physician workgroup of the American Academy of Hospice and Palliative Medicine sought to define Hospice and Palliative Medicine (HPM) EPAs. OBJECTIVE: The objective of this study was to describe the development of a set of consensus EPAs for HPM fellowship training in the United States...
October 2017: Journal of Pain and Symptom Management
Amy L Pittenger, Debra A Copeland, Matthew M Lacroix, Quamrun N Masuda, Peter Mbi, Melissa S Medina, Susan M Miller, Scott K Stolte, Cecilia M Plaza
The purpose of this report is to: 1) Identify linkages across the EPA statements, Center for the Advancement of Pharmacy Education 2013 Educational Outcomes (CAPE 2013) and the Joint Commission of Pharmacy Practitioners' Pharmacist Patient Care Process (PPCP); 2) Provide ways EPA statements can be used to communicate core skills that are part of the entry-level pharmacist identity; 3) Suggest a potential roadmap for AACP members on how to implement EPA statements.
June 2017: American Journal of Pharmaceutical Education
D Michael Elnicki, Meenakshy K Aiyer, Maria L Cannarozzi, Alexander Carbo, Paul R Chelminski, Shobhina G Chheda, Saumil M Chudgar, Heather E Harrell, L Chad Hood, Michelle Horn, Karnjit Johl, Gregory C Kane, Diana B McNeill, Marty D Muntz, Anne G Pereira, Emily Stewart, Heather Tarantino, T Robert Vu
The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies...
November 2017: Journal of General Internal Medicine
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