Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training

Woodworth, Glenn E.; Marty, Adrian; Tanaka, Pedro Paulo; Ambardekar, Aditee; Chen, Fei; Duncan, Michael; Fromer, Ilana R.; Hallman, Matthew R.; Klesius, Lisa L.; Ladlie, Beth L.; Mitchell, Sally A.; Juve, Amy K. Miller; McGrath, Brian J.; Shepler, John; Sims, Charles R.; Spofford, Christina M.; Cleve, Wil Van; Maniker, Robert B.

doi:10.1213/ane.0000000000005434

Cited by 22 publications

(42 citation statements)

References 40 publications

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“…Panelists were provided with a template and an example. The example provided was used successfully in previous EPA development studies 7. The definition of each EPA detailed the key features of both a simple and complex EPA including: the focus of the EPA, aspects of observation, and procedural requirements.…”

Section: Methodsmentioning

confidence: 99%

“…The entrustment levels were based on an existing entrustment scale, which is a modification of the Ottawa Clinical Assessment Scale (table 1). 7 11…”

Section: Methodsmentioning

confidence: 99%

“…Thus, EPAs are well aligned with faculty concepts of trainee competence—how much do they trust the trainee to perform the task 5. EPAs have been successfully piloted in anesthesiology residency programs 6 7. EPAs can serve as the cornerstone of assessments within a programmatic system of assessment designed to address all of the milestones and learning outcomes in a CBME training program 8…”

Section: Introductionmentioning

confidence: 99%

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Development of entrustable professional activities for regional anesthesia and pain medicine fellowship training

Porter

Prendiville

Allen

et al. 2022

Reg Anesth Pain Med

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IntroductionThe Accreditation Council for Graduate Medical Education (ACGME) offers descriptions of competencies and milestones but does not provide standardized assessments to track trainee competency. Entrustable professional activities (EPAs) and special assessments (SAs) are emerging methods to assess the level of competency obtained by regional anesthesiology and acute pain medicine (RAAPM) fellows.MethodsA panel of RAAPM physicians with experience in education and competency assessment and one medical student were recruited to participate in a modified Delphi method with iterative rounds to reach consensus on: a list of EPAs, SAs, and procedural skills; detailed definitions for each EPA and SA; a mapping of the EPAs and SAs to the ACGME milestones; and a target level of entrustment for graduating US RAAPM fellows for each EPA and procedural skill. A gap analysis was performed and a heat map was created to cross-check the EPAs and SAs to the ACGME milestones.ResultsParticipants in EPA and SA development included 19 physicians and 1 medical student from 18 different programs. The Delphi rounds yielded a final list of 23 EPAs, a defined entrustment scale, mapping of the EPAs to ACGME milestones, and graduation targets. A list of 73 procedural skills and 7 SAs were similarly developed.DiscussionA list of 23 RAAPM EPAs, 73 procedural skills, and 7 SAs were created using a rigorous methodology to reach consensus. This framework can be utilized to help assess RAAPM fellows in the USA for competency and allow for meaningful performance feedback.

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Section: Methodsmentioning

confidence: 99%

“…The entrustment levels were based on an existing entrustment scale, which is a modification of the Ottawa Clinical Assessment Scale (table 1). 7 11…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development of entrustable professional activities for regional anesthesia and pain medicine fellowship training

Porter

Prendiville

Allen

et al. 2022

Reg Anesth Pain Med

View full text Add to dashboard Cite

show abstract

“…EPAs can enable assessment in CBME by mapping to all the desired competencies. 11 Furthermore, they can be scaffolded for demonstrable progression of increased resident autonomy and responsibility in patient care on the path to independent practice. 12…”

Section: Where Is Cbme Now?mentioning

confidence: 99%

“…More recently, 20 EPAs that map to the ACGME anesthesiology milestones have been rigorously developed to facilitate resident assessment by anesthesiology training programs in the United States. 11…”

Section: Where Is Cbme Now?mentioning

confidence: 99%

Competency-Based Medical Training in Anesthesiology: Has It Delivered on the Promise of Better Education?

Kealey

Naik

2022

Anesthesia &Amp; Analgesia

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Better together: A multistakeholder approach to developing specialty‐wide entrustable professional activities in emergency medicine

Caretta‐Weyer,

Sebok‐Syer,

Morris

et al. 2024

AEM Education and Training

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PurposeEntrustable professional activities (EPAs) are a widely used framework for curriculum and assessment, yet the variability in emergency medicine (EM) training programs mandates the development of EPAs that meet the needs of the specialty as a whole. This requires eliciting and incorporating the perspectives of multiple stakeholders (i.e., faculty, residents, and patients) in the development of EPAs. Without a shared understanding of what a resident must be able to do upon graduation, we run the risk of advancing ill‐prepared residents that may provide inconsistent care.MethodsIn an effort to address these challenges, beginning in February 2020, the authors assembled an advisory board of 25 EM faculty to draft and reach consensus on a final list of EPAs that can be used across all training programs within the specialty of EM. Using modified Delphi methodology, the authors came to consensus on an initial list of 22 EPAs. The authors presented these EPAs to faculty supervisors, residents, and patients for refinement. The authors collated and analyzed feedback from focus groups of residents and patients using thematic analysis. The EPAs were subsequently refined based on this feedback.ResultsStakeholders in EM residency training endorsed a final revised list of 22 EPAs. Stakeholder focus groups highlighted two main thematic considerations that helped shape the finalized list of EM EPAs: attention to the meaningful nuances of EPA language and contextualizing the EPAs and viewing them developmentally.ConclusionsTo foreground all key stakeholders within the EPA process for EM, the authors chose within the development process to draft; come to consensus; and refine EPAs for EM in collaboration with relevant faculty, patient, and resident stakeholders. Each stakeholder group contributed meaningfully to the content and intended implementation of the EPAs. This process may serve as a model for others in developing stakeholder‐responsive EPAs.

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Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training

Abstract: An initial pre-defined list of preliminary EPA titles was derived from the EPA titles for anesthesiology training developed by the Royal College of Physicians and Surgeons of Canada 19 and those developed for anesthesiology training in the Netherlands.

Cited by 22 publications

References 40 publications

Development of entrustable professional activities for regional anesthesia and pain medicine fellowship training

Development of entrustable professional activities for regional anesthesia and pain medicine fellowship training

Competency-Based Medical Training in Anesthesiology: Has It Delivered on the Promise of Better Education?

Better together: A multistakeholder approach to developing specialty‐wide entrustable professional activities in emergency medicine

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