Severin Pinilla1,2, Eric Lenouvel3, Andrea Cantisani4, Stefan Klöppel3, Werner Strik4, Sören Huwendiek5, Christoph Nissen4. 1. University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. severin.pinilla@upd.unibe.ch. 2. Department for Assessment and Evaluation, Institute for Medical Education, University of Bern, Bern, Switzerland. severin.pinilla@upd.unibe.ch. 3. University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. 4. University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. 5. Department for Assessment and Evaluation, Institute for Medical Education, University of Bern, Bern, Switzerland.
Abstract
BACKGROUND: Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. METHODS: We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. RESULTS: We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. CONCLUSIONS: There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.
BACKGROUND: Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. METHODS: We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. RESULTS: We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. CONCLUSIONS: There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.
Entities:
Keywords:
Clinical education; Entrustable professional activities; Scoping review; Undergraduate medical education
Authors: 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 Journal: J Gen Intern Med Date: 2017-06-20 Impact factor: 5.128
Authors: T Robert Vu; Allison H Ferris; Michelle L Sweet; Steven V Angus; Nadia J Ismail; Emily Stewart; Jonathan S Appelbaum; Brian Kwan Journal: J Gen Intern Med Date: 2019-07 Impact factor: 5.128
Authors: 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 Journal: Acad Med Date: 2018-03 Impact factor: 6.893
Authors: Andrew S Parsons; Kelley Mark; James R Martindale; Megan J Bray; Ryan P Smith; Elizabeth Bradley; Maryellen Gusic Journal: J Gen Intern Med Date: 2022-06-16 Impact factor: 6.473
Authors: Tasslem von Streng Paats; Tahir Masud; Sören Huwendiek; Adrian Blundell; Michael Vassallo; Andreas E Stuck Journal: Age Ageing Date: 2022-05-01 Impact factor: 12.782