In this article we address the concept of burnout, first in the medical student setting, and then in the residency setting. We will review the prevalence followed by a discussion of risk factors, consequences, and finally thoughts on prevention and intervention.
PURPOSE: To describe the development of a school wide and longitudinal assessment of the core Entrustable Professional Activity (EPA)s using an easily accessible App. BACKGROUND: Our institution is part of the EPA pilot study sponsored by the AAMC to explore the feasibility of teaching and assessing the core EPAs. This year direct observation and assessment of the EPAs was implemented across clerkships. Each clerkship was allowed to determine which EPAs were applicable to their field. METHODS: The OBGYN department determined and assessed that EPA1 (History and Physical), EPA2 (Differential Dx), EPA3 (Dx and Screening Tests) and EPA6 (Oral Presentation) were core skills to the clerkship with the following scale (1=student observed, 2=assessor had to talk the student through it, 3=assessor had direct them from time to time, and 4=assessor needed to be available just in case.). RESULTS: EPA 1 was 3.0 for OB vs 3.5 for other clerkships (p<.0001). For EPA 2 OB was 3.0 vs 3.4 for other clerkships (p<0.05). For EPA 3 OB was at 3.0 vs 3.4 for other clerkships (n.s). For EPA 6 OB was at 3.1 vs 3.4 for other clerkships (p<.005). For the first 3 months there were 2783 EPA assessments. The average score was 3.45. In comparison to other clerkships, students on OBGYN received lower scores in EPA 1,2,6. (P<.0001, P<.05 and P<.005) possibly indicating more stringent grading by faculty or lower performance of medical students. For the first 3 months there were 2783 EPA assessments. The average score was 3.45. In comparison to other clerkships, students on OBGYN received lower scores in EPA 1,2,6. (P<.0001, P<.05 and P<.005) possibly indicating more stringent grading by faculty or lower performance of medical students. DISCUSSION: In comparison to all other clerkships combines, student on OBGYN received lower scores in all four EPAs possibly indicating more stringent grading by faculty or lower performance of medical students. Lower EPA scores may indicate more stringent grading by faculty or lower performance of medical students. This could also be related to lower numbers of overall EPAs required by the OB/GYN clerkship. Further research is needed to determine the significance of these findings.
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