Background
The Next Accreditation System (NAS) increases the focus on educational outcomes and meaningful evaluation of learners. This requires that key clinical faculty develop new assessment formats such as entrustable professional activities (EPAs).
Objectives
To build and develop milestone-based assessment tools supporting 5 EPAs for a hematology/oncology fellow continuity clinic, and to educate key clinical faculty regarding the Clinical Competency Committee (CCC) and the NAS.
Methods
Program directors from 2 hematology/oncology fellowship programs developed 5 EPAs for continuity clinic evaluation supported by milestone-based assessment. The program directors met to create a unified CCC charter. Key clinical faculty helped to develop a milestone-based evaluation of fellow continuity clinic through creation of 5 hematology/oncology-specific EPAs. Formal entrustment regarding EPAs was deliberated by the CCC.
Results
A total of 18 fellows were evaluated. Clinical Competency Committee deliberation at each institution took approximately 10 minutes per fellow for discussion and decision regarding entrustment for all 5 EPAs supporting continuity clinic. One-third of postgraduate year (PGY)–4s, 50% of PGY-5s, and 100% of PGY-6s were deemed competent in all 5 EPAs by the CCC.
Conclusions
All hematology/oncology trainees in San Antonio were evaluated using milestone-based assessment for continuity clinic, and entrustment decisions regarding 5 EPAs were made by the CCC. This project may provide other programs with a sound basis for adoption and further development of the next generation of evaluation tools at their institutions. Entrustable professional activities that are rotation specific should be used as a starting point for linking to the competencies, subcompetencies, and the reporting milestones.
Women comprise three quarters of students who graduate from psychology doctoral programs (Cope, Michalski, & Folwer, 2016), but gender disparity in pay and position prestige persist in the workforce (American Psychological Association, 2018;Wicherski, Mulvey, Hart, & Kohout, 2011). Women who are mothers may experience a "maternal wall" (Crosby, Williams, & Biernat, 2004;Williams, 2005) that further impedes professional advancement. Because supervisors are positioned to facilitate trainees' professional development and supervision processes have been found to differ based on gender (Chung, Marshall, & Gordon, 2001;Granello, 2003;Hindes & Andrews, 2011), more work is needed to highlight the unique challenges faced by trainees who are mothers and to demonstrate how supervisors' behaviors can help trainees navigate these challenges. This article describes supervisory experiences of trainees who identified as new mothers during clinical internship. Authors share paraphrased supervision interactions on topics positioned at the intersection of training and motherhood to illustrate how supervisors impacted trainees who were navigating these challenges. Authors identify gender-based discrimination as harmful to the supervisory alliance and highlight self-disclosure, flexibility, and corrective feedback as supervisor behaviors that enhance the supervisory alliance and support trainees. The discussion section situates trainees' needs in the context of national and site policies that impact mothers.
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