Appraisal of the entrustable professional activities (EPAs) patient care provider domain by North Dakota pharmacists

Abstract

Background:Entrustable Professional Activities (EPAs) are the latest addition to a list of professional competencies that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy.Objective:The study’s objective is to assess the use of Core EPAs in the patient care domain (by practice setting, position, and preceptor status) in contemporary pharmacy practice.Methods:This survey assessed the EPA activities of pharmacists practicing in North Dakota. The pharmacists were asked “how many times in the past 30 days have you delivered the following services in your practice setting?” Response options were: 0, 1, 2, 3, 4, and 5 or more times.Results:Of 990 potential respondents, 457 pharmacists (46.1%) returned a survey, and 107 (10.8%) answered every survey item in the patient care domain. Respondents reported that the highest rated activity items “Collect information to identify a patient’s medication-related problems and health-related needs,” and “Analyze information to determine the effects of medication therapy, identify medication-related problems, and prioritize health-related needs” were performed an average of 3.9 times per week (SD=1.8), and 3.8 times per week (SD=2.0), respectively. Both of these items, were reported for 70% of the respondents at 5 or more times per week. For these items, the highest reported practice setting was ‘other’ practice settings (e.g., long-term care, community health centers) followed by chains, hospitals, and independent pharmacies. By position, clinical pharmacists and preceptors reported the highest activity levels for most EPAs and supportive example tasks.Conclusions:This study provides empirical evidence suggesting (but not proving) that EPAs have potential as a means to assess outcomes in pharmacy education and practice. Our study sets the stage for future work that further refines and assesses core EPA activities and supportive example tasks to measure the impact of how this process relates to outcomes of care.

Evaluation of the entrustable professional activities (EPAs) of the population health promoter domain by North Dakota pharmacists

“…The second section lists each core EPA, along with supporting tasks. 10 , 11 Based on the literature and the authors’ collective knowledge of pharmacy practice, the authors determined that the vast majority of practicing pharmacists would undertake activities in the practice manager EPA with much greater frequency than activities in other types of domains. This greater frequency of use allows respondents to report their perceptions of these tasks with an extremely high degree of consistency, accuracy and precision.…”

“…More than half of its counties have population densities of less than six people per square mile and are designated by the U.S. Health Resources and Services Administration as “frontier counties”. 10 , 11 Concomitantly, four communities in the state (Fargo, Grand Forks, Bismarck, and Minot) have populations of 25,000 or more residents. The latter are typically categorized as “urban” communities, while all other communities are categorized as “rural”.…”

“…The latter are typically categorized as “urban” communities, while all other communities are categorized as “rural”. 10 , 11 …”

“…Given these considerations, and consistent with the EPA literature, a decision was made to report results in two forms. 10 , 11 First, for approximately ordinal (i.e., non-truncated) variables, traditional means and standard deviations are reported. For variables that are potentially truncated, the proportion of responses at the truncation point (i.e., the proportion of responses reporting that they perform a task “5 or more times in the last 30 days”) is reported.…”

“…Previous studies have examined the perceived frequency of EPA use (both overall and across practice settings, by preceptor status, and by the type of position/responsibility) in the Patient Care Provider (PCP) and Practice Management (PM) domains. 10 , 11 Substantial differences were found in the perceived frequency of use across various practice settings. However, little is known about the perceived use of EPAs in the other four domains.…”