Spencer Sample1, Hussein Al Rimawi1, Beatrix Bérczi1, Alexander Chorley1,2,3, Alim Pardhan1,2, Teresa M Chan1,2,3,4. 1. Emergency Medicine Postgraduate Training Program McMaster Royal College of Physicians and Surgeons of Canada Hamilton Ontario Canada. 2. Division of Emergency Medicine, Department of Medicine, Faculty of Health Sciences McMaster University Hamilton Ontario Canada. 3. McMaster Education Research, Innovation, and Theory (MERIT) Hamilton Ontario Canada. 4. Division of Education and Innovation, Department of Medicine, Faculty of Health Sciences McMaster University Hamilton Ontario Canada.
Abstract
INTRODUCTION: Within the Canadian competency-based medical education system, entrustable professional activities (EPAs) are used to assess residents on performed clinical duties. This study aimed to determine whether implementing a bundle of two interventions (a case-based discussion intervention and a rotation-based nudging system) could increase the number of EPA assessments that could occur for our trainees. METHODS: The authors designed an intervention bundle with two components: 1) a case-based workshop where trainees discussed which EPAs could be assessed with multiple cases and 2) a nudging system wherein each trainee was reminded of EPAs that would be useful to them on each rotation in their first year. We conducted a retrospective program evaluation to compare the intervention cohort (2019) to two historical cohorts using similar EPAs (2017, 2018). RESULTS: Data from 22 trainees (seven in 2017, eight in 2018, and seven in 2019) were analyzed. There was a marked increase in the total number of EPA assessments acquired in the 2019 cohort (average per resident = 285.7, 95% confidence interval [CI] = 256.1 to 312.3, range = 195-350) compared to the two other years (2018 [average = 132.4, 95% CI = 107.5 to 157.02, range = 107-167] and 2017 [70.1, 95% CI 45.3 to 91.0, range = 49-95]), yielding an effect size of Cohen's d = 4.02 for our intervention bundle. CONCLUSIONS: Within the limitations of a small sample size, there was a strong effect of introducing two interventions (a case-based orientation and a nudging system) upon EPA assessments with PGY-1 residents. These strategies may be useful to others seeking to improve EPA assessment numbers in other specialties and clinical environments.
INTRODUCTION: Within the Canadian competency-based medical education system, entrustable professional activities (EPAs) are used to assess residents on performed clinical duties. This study aimed to determine whether implementing a bundle of two interventions (a case-based discussion intervention and a rotation-based nudging system) could increase the number of EPA assessments that could occur for our trainees. METHODS: The authors designed an intervention bundle with two components: 1) a case-based workshop where trainees discussed which EPAs could be assessed with multiple cases and 2) a nudging system wherein each trainee was reminded of EPAs that would be useful to them on each rotation in their first year. We conducted a retrospective program evaluation to compare the intervention cohort (2019) to two historical cohorts using similar EPAs (2017, 2018). RESULTS: Data from 22 trainees (seven in 2017, eight in 2018, and seven in 2019) were analyzed. There was a marked increase in the total number of EPA assessments acquired in the 2019 cohort (average per resident = 285.7, 95% confidence interval [CI] = 256.1 to 312.3, range = 195-350) compared to the two other years (2018 [average = 132.4, 95% CI = 107.5 to 157.02, range = 107-167] and 2017 [70.1, 95% CI 45.3 to 91.0, range = 49-95]), yielding an effect size of Cohen's d = 4.02 for our intervention bundle. CONCLUSIONS: Within the limitations of a small sample size, there was a strong effect of introducing two interventions (a case-based orientation and a nudging system) upon EPA assessments with PGY-1 residents. These strategies may be useful to others seeking to improve EPA assessment numbers in other specialties and clinical environments.
Authors: Elaine Van Melle; Jason R Frank; Eric S Holmboe; Damon Dagnone; Denise Stockley; Jonathan Sherbino Journal: Acad Med Date: 2019-07 Impact factor: 6.893
Authors: Andrew K Hall; Markku T Nousiainen; Paolo Campisi; J Damon Dagnone; Jason R Frank; Karen I Kroeker; Stacey Brzezina; Eve Purdy; Anna Oswald Journal: Med Teach Date: 2020-05-25 Impact factor: 3.650
Authors: Jonathan Sherbino; Glen Bandiera; Ken Doyle; Jason R Frank; Brian R Holroyd; Gord Jones; Joanne Norum; Carolyn Snider; Kirk Magee Journal: CJEM Date: 2020-01 Impact factor: 2.410
Authors: Brent Thoma; Andrew K Hall; Kevin Clark; Nazanin Meshkat; Warren J Cheung; Pierre Desaulniers; Cheryl Ffrench; Allison Meiwald; Christine Meyers; Catherine Patocka; Lorri Beatty; Teresa M Chan Journal: J Grad Med Educ Date: 2020-08