Olle Ten Cate1, Lysanne Graafmans1,2, Indra Posthumus1,3, Lisanne Welink4, Marijke van Dijk5. 1. a Center for Research and Development of Education , University Medical Center , Utrecht , The Netherlands. 2. b Department of Medical Education, Education Center , University Medical Center , Utrecht , The Netherlands. 3. c Department of Dermatology , Bravis Hospital , Bergen op Zoom , The Netherlands. 4. d Department of General Practice, Julius Center for Health Sciences and Primary Care , University Medical Center, Utrecht , The Netherlands. 5. e Department of Pathology , University Medical Center, Utrecht, The Netherlands.
Abstract
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. RESULTS: In the resulting curriculum, operational from 2016, students train to be trusted with indirect supervision before graduation in five broad EPAs: the clinical consultation; general medical procedures; informing, advising and guiding patients and families; communicating and collaborating with colleagues; and extraordinary patient care. Each of these integrates smaller (nested) EPAs that receive focused training attention in integrated clerkships at various moments and must be signed off for entrustment with indirect supervision to complete the clerkship. DISCUSSION: The framework of EPAs went through many iterations before it was consolidated. Among the issues that required special attention was the application of a supervision levels scale for sign-off, the necessity to cover all relevant clinical content while not labeling too many small tasks each as a separate EPA, methods of EPA-focused assessment in the workplace and the creation of an e-portfolio model to serve assessment and entrustment.
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. RESULTS: In the resulting curriculum, operational from 2016, students train to be trusted with indirect supervision before graduation in five broad EPAs: the clinical consultation; general medical procedures; informing, advising and guiding patients and families; communicating and collaborating with colleagues; and extraordinary patient care. Each of these integrates smaller (nested) EPAs that receive focused training attention in integrated clerkships at various moments and must be signed off for entrustment with indirect supervision to complete the clerkship. DISCUSSION: The framework of EPAs went through many iterations before it was consolidated. Among the issues that required special attention was the application of a supervision levels scale for sign-off, the necessity to cover all relevant clinical content while not labeling too many small tasks each as a separate EPA, methods of EPA-focused assessment in the workplace and the creation of an e-portfolio model to serve assessment and entrustment.
Authors: Elske Hissink; Wietske A Fokkinga; Ronald R M Leunissen; C R M G Lia Fluit; A F M Loek Nieuwenhuis; Nico H J Creugers Journal: Eur J Dent Educ Date: 2021-02-12 Impact factor: 2.528