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Entrustable professional activities

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
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
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
Pooja Sharma, Nadeem Tanveer, Aditi Goyal
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 1 st year pathology residents...
January 2018: Journal of Laboratory Physicians
Michael W Manning, Eric W Bean, Andrew C Miller, Suzanne J Templer, Richard S Mackenzie, David M Richardson, Kristin A Bresnan, Marna R Greenberg
Introduction: The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism)...
January 2018: Western Journal of Emergency Medicine
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
Kerry Wilbur
No abstract text is available yet for this article.
November 2017: Canadian Journal of Hospital Pharmacy
Nobuko Hagiwara
The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care...
2017: Advances in Medical Education and Practice
Craig McIlhenny, Yo Kurashima, Carlos Chan, Satoshi Hirano, Ismael Domínguez-Rosado, Dimitrios Stefanidis
Surgical education has seen tremendous changes in the US over the past decade. The Halstedian training model of see one, do one, teach one that governed surgical training for almost 100 years has been replaced by the achievement of the ACGME competencies, milestones, entrustable professional activities (EPAs), and acquisition of surgical skill outside the operating room on simulators. Several of these changes in American medical education have been influenced by educators and training paradigms abroad. In this paper, we review the training paradigms for surgeons in the UK, Japan, and Mexico to allow comparisons with the US training paradigm and promote the exchange of ideas...
February 2018: American Journal of Surgery
Folkert Fehr, Christoph Weiß-Becker, Hera Becker, Thomas Opladen
There is an absence of broad-based and binding curricular requirements for structured competency-based post-graduate medical training in Germany, and thus no basis for comparing the competencies of physicians undergoing training in a medical specialty ( Ärzte im Weiterbildung ). In response, the German Society of Primary Care Pediatrics' working group on post-graduate education (DGAAP) has identified realistic entrustable professional activities (EPAs) in primary care, defined their number, scope and content, selected competency domains, specified required knowledge and skills, and described appropriate assessment methods...
2017: GMS Journal for Medical Education
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
Gersten Jonker, Reinier G Hoff, Stefan Max, Cor J Kalkman, Olle Ten Cate
Objective: A well-designed final year may ease the transition from medical school to postgraduate training, if it has enough depth to enable the acquisition of early specialty expertise, while keeping enough breadth to support the graduation as all-round physician. Aim of this article is to describe the design of a multidisciplinary dedicated transitional year (DTY) around the theme of recognition and initial treatment of vitally threatened patients. Methods: Undergraduate and postgraduate training directors from the departments of Anaesthesiology, Cardiology, Emergency Medicine, Intensive Care Medicine and Respiratory Medicine at UMC Utrecht and partnering hospitals have collaboratively developed and implemented a curriculum for a final year focusing on three entrustable professional activities (EPAs) in the domain of acute care...
2017: GMS Journal for Medical Education
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