Richard B Mink1, Alan Schwartz, Bruce E Herman, David A Turner, Megan L Curran, Angela Myers, Deborah C Hsu, Jennifer C Kesselheim, Carol L Carraccio. 1. R.B. Mink is professor of pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, and chief, Division of Pediatric Critical Care Medicine, and director, Pediatric Critical Care Medicine Fellowship, Harbor-UCLA Medical Center, Torrance, California. A. Schwartz is Michael Reese Endowed Professor of Medical Education, associate head, Department of Medical Education, and research professor, Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, Illinois. B.E. Herman is professor of pediatrics, vice chair for education, and residency program director, University of Utah School of Medicine, Salt Lake City, Utah. D.A. Turner is associate professor of pediatrics, Duke University School of Medicine, and associate director of graduate medical education, Duke University Medical Center, Durham, North Carolina. M.L. Curran is assistant professor of pediatrics and director, Pediatric Rheumatology Fellowship Program, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois. A. Myers is associate professor and director, Infectious Diseases Fellowship Program, Children's Mercy Hospital and University of Missouri-Kansas City School of Medicine, Kansas City, Missouri. D.C. Hsu is associate professor of pediatrics, associate program director, Pediatric Residency Program, and clinical and education chief, Pediatric Emergency Medicine Section, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas. J.C. Kesselheim is assistant professor of pediatrics, Harvard Medical School, and associate fellowship program director for education, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts. C.L. Carraccio is vice president, Competency-Based Assessment, American Board of Pediatrics, Chapel Hill, North Carolina.
Abstract
PURPOSE: Entrustable professional activities (EPAs) represent the routine and essential activities that physicians perform in practice. Although some level of supervision scales have been proposed, they have not been validated. In this study, the investigators created level of supervision scales for EPAs common to the pediatric subspecialties and then examined their validity in a study conducted by the Subspecialty Pediatrics Investigator Network (SPIN). METHOD: SPIN Steering Committee members used a modified Delphi process to develop unique scales for six of the seven common EPAs. The investigators sought validity evidence in a multisubspecialty study in which pediatric fellowship program directors and Clinical Competency Committees used the scales to evaluate fellows in fall 2014 and spring 2015. RESULTS: Separate scales for the six EPAs, each with five levels of progressive entrustment, were created. In both fall and spring, more than 300 fellows in each year of training from over 200 programs were assessed. In both periods and for each EPA, there was a progressive increase in entrustment levels, with second-year fellows rated higher than first-year fellows (P < .001) and third-year fellows rated higher than second-year fellows (P < .001). For each EPA, spring ratings were higher (P < .001) than those in the fall. Interrater reliability was high (Janson and Olsson's iota = 0.73). CONCLUSIONS: The supervision scales developed for these six common pediatric subspecialty EPAs demonstrated strong validity evidence for use in EPA-based assessment of pediatric fellows. They may also inform the development of scales in other specialties.
PURPOSE: Entrustable professional activities (EPAs) represent the routine and essential activities that physicians perform in practice. Although some level of supervision scales have been proposed, they have not been validated. In this study, the investigators created level of supervision scales for EPAs common to the pediatric subspecialties and then examined their validity in a study conducted by the Subspecialty Pediatrics Investigator Network (SPIN). METHOD: SPIN Steering Committee members used a modified Delphi process to develop unique scales for six of the seven common EPAs. The investigators sought validity evidence in a multisubspecialty study in which pediatric fellowship program directors and Clinical Competency Committees used the scales to evaluate fellows in fall 2014 and spring 2015. RESULTS: Separate scales for the six EPAs, each with five levels of progressive entrustment, were created. In both fall and spring, more than 300 fellows in each year of training from over 200 programs were assessed. In both periods and for each EPA, there was a progressive increase in entrustment levels, with second-year fellows rated higher than first-year fellows (P < .001) and third-year fellows rated higher than second-year fellows (P < .001). For each EPA, spring ratings were higher (P < .001) than those in the fall. Interrater reliability was high (Janson and Olsson's iota = 0.73). CONCLUSIONS: The supervision scales developed for these six common pediatric subspecialty EPAs demonstrated strong validity evidence for use in EPA-based assessment of pediatric fellows. They may also inform the development of scales in other specialties.
Authors: Richard Mink; Bruce E Herman; Carol Carraccio; Tandy Aye; Jeanne M Baffa; Patricia R Chess; Jill J Fussell; Cary G Sauer; Diane E J Stafford; Pnina Weiss; Megan L Curran; Christiane E L Dammann; Pamela C High; Deborah Hsu; Jennifer C Kesselheim; John D Mahan; Kathleen A McGann; Angela L Myers; Sarah Pitts; David A Turner; Alan Schwartz Journal: J Med Educ Curric Dev Date: 2020-08-06
Authors: Sanne Schreurs; Kitty Cleutjens; Carlos F Collares; Jennifer Cleland; Mirjam G A Oude Egbrink Journal: Adv Health Sci Educ Theory Pract Date: 2019-10-09 Impact factor: 3.853
Authors: Muhammad Zafar Iqbal; Karen D Könings; Mohamed Al-Eraky; Mona Hmoud AlSheikh; Jeroen J G van Merrienboer Journal: Med Educ Online Date: 2020-12
Authors: Daniel J Schumacher; Daniel C West; Alan Schwartz; Su-Ting Li; Leah Millstein; Elena C Griego; Teri Turner; Bruce E Herman; Robert Englander; Joni Hemond; Valera Hudson; Lauren Newhall; Kenya McNeal Trice; Julie Baughn; Erin Giudice; Hannah Famiglietti; Jonathan Tolentino; Kimberly Gifford; Carol Carraccio Journal: JAMA Netw Open Date: 2020-01-03