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James A McClintic, Clifford L Snyder, Kimberly M Brown
OBJECTIVE: Although key clinical skills have been defined in the Core Entrustable Professional Activities, there is a need to improve medical school curricula with standardized training opportunities and assessments of these skills. Thus, we aimed to develop an innovative curriculum that emphasized critical thinking and clinical skills. We hypothesized that we would be able to observe measurable improvement on assessments of students' critical thinking and clinical skills after the implementation of the new curriculum...
March 12, 2018: Journal of Surgical Education
Laura M Wagner, Mary A Dolansky, Robert Englander
BACKGROUND: Further efforts are warranted to identify innovative approaches to best implement competencies in nursing education. To bridge the gap between competency-based education, practice, and implementation of knowledge, skills, and attitudes, one emerging approach is entrustable professional activities (EPAs). PURPOSE: The objective of this study was to introduce the concept of EPAs as a framework for curriculum and assessment in graduate nursing education and training...
November 22, 2017: Nursing Outlook
Eric G Meyer, William F Kelly, Paul A Hemmer, Louis N Pangaro
No abstract text is available yet for this article.
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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
Robert Hermann, Hartmut Derendorf, Oliver von Richter, Amin Rostami-Hodjegan
No abstract text is available yet for this article.
March 7, 2018: Journal of Clinical Pharmacology
Olle Ten Cate
Entrustable professional activities (EPAs) have become a popular topic within competency-based medical education programs in many countries and hundreds of publications within only a few years. This paper was written to introduce the ins and outs of EPAs. After a brief historical overview, the rational of EPAs, as a bridge between a competency framework and daily clinical practice, is explained. Next, entrustment decision-making as a form of assessment is elaborated and framework of levels of supervision is presented...
March 2018: Korean Journal of Medical Education
J Breckwoldt, S K Beckers, G Breuer, A Marty
Entrustable professional activities (EPAs) are characterized as self-contained units of work in a given typical clinical context, which may be entrusted to a trainee for independent execution at a certain point of training. An example could be the intraoperative anesthesia management of an ASA 1 patient for an uncomplicated surgical intervention as an EPA in early postgraduate anesthesia training. The EPAs can be described as an evolution of a competency-based medical educational concept, applying the concept of the competencies of a person to specific workplace contexts...
March 2, 2018: Der Anaesthesist
Kimberly D Lomis, Vivian T Obeso, Alison J Whelan
No abstract text is available yet for this article.
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
George C Mejicano, Tracy N Bumsted
Oregon Health & Science University School of Medicine launched a completely new undergraduate medical education curriculum in 2014. This initiative dramatically transformed the MD degree program, changing the instructional content taught, the pedagogical methods used by the faculty, and the methods of assessment, and it added new elements such as academic coaching and programmatic entrustment to the program. One of the most exciting and impactful aspects to date of this curricular transformation has been the deliberate implementation of a competency-based framework that incorporates frequent assessment, tracking of student progression using an electronic portfolio, and academic coaching to optimize learning and customize curricular elements for each student...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Reinier G Hoff, Joost Frenkel, Saskia M Imhof, Olle Ten Cate
Postgraduate medical training in the Netherlands has become increasingly individualized. In this article, the authors describe current practices for three residency programs at the University Medical Center Utrecht: anesthesiology, pediatrics, and ophthalmology. These programs are diverse yet share characteristics allowing for individualized residency training. New residents enter each program throughout the year, avoiding a large simultaneous influx of inexperienced doctors. The usual duration of each is five years...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Olle Ten Cate, Larry D Gruppen, Jennifer R Kogan, Lorelei A Lingard, Pim W Teunissen
The introduction of competency-based medical education has shifted thinking from a fixed-time model to one stressing attained competencies, independent of the time needed to arrive at those competencies. In this article, the authors explore theoretical and conceptual issues related to time variability in medical training, starting with the Carroll model from the 1960s that put time in the equation of learning. They discuss mastery learning, deliberate practice, and learning curves.While such behaviorist theories apply well to structured courses and highly structured training settings, learning in the clinical workplace is not well captured in such theories or in the model that Carroll proposed...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Neal R Chamberlain, Patricia S Sexton, Matthew R Hardee, Robert W Baer
Context: Thirteen entrustable professional activities (EPAs) for entering residency were created to aid medical educators as they prepare preclinical students for their residency and to assess student readiness for residency. The A.T. Still University Kirksville College of Osteopathic Medicine (ATSU-KCOM) developed a program called physician-mentored patient rounds (PMPR), which focuses on EPA 1 and EPA 2. Objective: To determine whether PMPRs could be used to assess expected behaviors of EPA 1 (gather a history and perform a physical examination) and EPA 2 (prioritize a differential diagnosis after a clinical encounter)...
March 1, 2018: Journal of the American Osteopathic Association
Kyoko Sudo, Jun Kobayashi, Shinichiro Noda, Yoshiharu Fukuda, Kenzo Takahashi
Elderly care is an emerging global issue threatening both developed and developing countries. The elderly in Japan increased to 26.7% of the population in 2015, and Japan is classified as a super-aged society. In this article, we introduce the financial aspects of the medical care and welfare services policy for the elderly in Japan. Japan's universal health insurance coverage system has been in place since 1961. Long-term care includes welfare services, which were separated from the medical care insurance scheme in 2000 when Japan was already recognized as an aging society...
February 26, 2018: Bioscience Trends
Muhammad Zafar Iqbal, Mohamed M Al-Eraky
Faculty development (FD) activities aim to improve teaching competencies. Success of these activities is conditioned with the ability of participants to transfer the learned competencies into their teaching practices. Unfortunately, evaluation of the effectiveness of FD rely mostly upon self-reported or verbal feedback, without valid evaluation of their progress in teaching performance. This shortcoming may be attributed to the unavailability of a systematic assessment system to evaluate participants' performance in the workplace...
February 23, 2018: Medical Teacher
Olle Ten Cate, Jan Borleffs, Marijke van Dijk, Tineke Westerveld
AIM: The aim of this report, written for the 40th anniversary issue of Medical Teacher, is to document 20 years of development of the Utrecht undergraduate medical curriculum, as both to exhibit accountability and to inform the community of the process and choices that can be made in long-term curriculum development. METHODS: We used the SPICES model, created by Medical Teacher's Editor Ronald Harden and colleagues in 1984. RESULTS: The Utrecht six-year program, now called "CRU+", has many distinct features that were introduced, most of which are well documented...
February 22, 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
Gurjit Sandhu, Julie Thompson-Burdine, Vahagn C Nikolian, Danielle C Sutzko, Kaustubh A Prabhu, Niki Matusko, Rebecca M Minter
Importance: A critical balance is sought between faculty supervision, appropriate resident autonomy, and patient safety in the operating room. Variability in the release of supervision during surgery represents a potential safety hazard to patients. A better understanding of intraoperative faculty-resident interactions is needed to determine what factors influence entrustment. Objective: To assess faculty and resident intraoperative entrustment behaviors and to determine whether faculty behaviors drive resident entrustability in the operating room...
February 21, 2018: JAMA Surgery
Thomas H Cogbill
No abstract text is available yet for this article.
February 21, 2018: JAMA Surgery
Xiaodong Phoenix Chen, Amy M Sullivan, Douglas S Smink, Adnan Alseidi, Joan M Bengtson, Gifty Kwakye, John L Dalrymple
OBJECTIVE: This study aimed to identify the empirical processes and evidence that expert surgical teachers use to determine whether to take over certain steps or entrust the resident with autonomy to proceed during an operation. BACKGROUND: Assessing real-time entrustability is inherent in attending surgeons' determinations of residents' intraoperative autonomy in the operating room. To promote residents' autonomy, it is necessary to understand how attending surgeons evaluate residents' performance and support opportunities for independent practice based on the assessment of their entrustability...
February 20, 2018: Annals of Surgery
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