BackgroundCompetency-based education has been considered the most important pedagogical trend in Medicine in the last two decades. In clinical contexts, competencies are implemented through Entrustable Professional Activities (EPAs) which are observable and measurable. The aim of this paper is to describe the methodology used in the design of educational tools to assess students´ competencies in clinical practice during their undergraduate internship (UI). In this paper, we present the construction of specific APROCs (Actividades Profesionales Confiables) in Surgery (S), Gynecology and Obstetrics (GO) and Family Medicine (FM) rotations with three levels of performance.MethodsThe study considered a mixed method exploratory type design, a qualitative phase followed by a quantitative validation exercise. In the first stage data was obtained from three rotations (FM, GO and S) through focus groups about real and expected activities of medical interns. Triangulation with other sources was made to construct benchmarks. In the second stage, narrative descriptions with the three levels were validated by professors who teach the different subjects using the Delphi technique.ResultsThe results may be described both curricular and methodological wise. From the curricular point of view, APROCs were identified in three UI rotations within clinical contexts in Mexico City, benchmarks were developed by levels and validated by experts’ consensus. In regard to methodological issues, this research contributed to the development of a strategy, following six steps, to build APROCs using mixed methods ConclusionsDeveloping benchmarks provides a regular and standardized language that helps to evaluate student’s performance and define educational strategies efficiently and accurately. The university academic program was aligned with APROCs in clinical contexts to assure the acquisition of competencies by students.
Objective: The aim of this study was to emphasize the importance of integrating the context to the construction of the specific Entrustable Professional Activities (EPA) for Undergraduate Medical Education (UME). Design: Mixed study with three phases: 1) Exploratory, we searched context with focus groups technique. 2) Construction, we analyzed academic program of our faculty and the national epidemiology. Therefore, we selected the contents and generated each EPA with its milestones and competence levels. 3) Implementation, we conformed a formative assessment tool which was tested at surgery rotation. Setting: We worked with 10 public and private health institutions of secondary and tertiary health care levels which were used as clinical settings for surgery rotation of fifth year medicine course at the Faculty of Medicine of Universidad Nacional Autónoma de México in Mexico City. Participants: In exploratory focus groups, were involved 10 surgeons and 12 medical students. At implementation 64 students participated and 25 gave feedback. All participants were involved voluntary for this study. Results: We constructed eleven surgery specific EPAs for UME, within specific context of the clinical environment of our faculty. Conclusions: We propose these EPAs because they reflected the most important topics or diseases in our country and as educative developers we support the idea that our graduates should be able to attend the population needs of health.
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