E‐portfolios and Entrustable Professional Activities to support competency‐based education in dietetics

Abstract

The concept of Entrustable Professional Activities, recently pioneered in medical education, has emerged to support the implementation of competency-based education. Although competency-based frameworks are widely used in healthcare professional education to develop outcomes-based curricula, assessment of student competency in professional placement settings remains challenging. The novel concept of Entrustable Professional Activities together with established methods of competency assessment, namely e-portfolios and self-assessment, was implemented in the "[La Trobe University Dietetic program in 2015-2016. This study aimed to appraise the e-portfolio and evaluate the use of Entrustable Professional Activities to assess competence. A mixed-methods evaluation, using qualitative and quantitative surveys with follow-up structured consultations, was conducted with final year dietetics students and their supervisors. Dietetics students were comfortable with Entrustable Professional Activities and competency-based assessment, whereas supervisors preferred Entrustable Professional Activity based assessment. All stakeholders valued student self-assessment and the ongoing use of structured eportfolios to develop and document competency. The use of structured e-portfolios, student self-assessment, and the emerging concept of Entrustable Professional Activities are useful tools to support dietetics student education in professional placement settings.

An online Delphi study to investigate the completeness of the CanMEDS Roles and the relevance, formulation, and measurability of their key competencies within eight healthcare disciplines in Flanders

“…After adding the enabling competencies, experts indeed rated one additional key competency as measurable. Literature shows that assessment indeed is the most challenging process when implementing a competency framework as competencies rather describe professional behavior than observable and measurable actions [ 7 ]. Van der Lee et al [ 45 ] confirm this statement, stressing how abstract and general descriptions of the Roles and key competencies provide a clear and relevant framework but emphasizing how underlying enabling competencies are needed to measure and assess these in educational settings.…”

“…Although these milestones reflect an emphasis on competency growth, they are insufficiently detailed to evaluate the actual development of competencies during an educational program [ 6 ]. The ACGME framework offers more detail in describing performance levels (novice, advanced beginner, competent, proficient, and resident/expert), but also these levels are insufficient to guide a developmental assessment of the competencies [ 7 ]. Also, taxonomies, such as Miller’s pyramid [ 49 ] and Dreyfus’ levels in skills acquisition [ 50 ] put forward levels but lack detail in only providing a vague description of expected performance levels.…”

“…Different overarching competency frameworks capturing CBE outcomes have been developed for medical education [ 3 , 7 ] such as the Canadian Medical Education Directives for Specialists (CanMEDS) [ 8 ], the Tomorrow’s Doctors [ 9 ], the Scottish Doctor [ 10 ], and the Accreditation Council for Graduate Medical Education (ACGME) [ 11 ]. Although at the surface, the competencies within each competency framework might differ, the competency descriptions mirror large similarities [ 3 ].…”

Transformation of learning and teaching in rehabilitation sciences: A case study from South Africa

“…They implemented the e-OSPE following a reduction in their divisional budget. Further review of the literature shows that e-portfolios are increasingly used in health professions education locally and abroad to evidence experience and competence (Bramley et al 2021;Haldane 2014;Haverkamp & Vogt 2015;Jenkins, Mash & Derese 2013). Producing a portfolio requires synthesis of ideas, reflection on achievement, self-awareness and forward planning (Park et al 2004;Yancey & Hunt 2009), all affordances that could motivate students to dedicate more time to practising newly acquired techniques.…”

Editorial

“…Similar to integrated care pathways that establish service structures to follow patient’s needs, the whole program approach would orientate curricula to the student’s progression and attainment of competency. For students to traverse the silos of modules and holistically manage their competency development, competency-based e-portfolios can be applied (Bramley et al , 2021). These enable a student to focus on their competency gaps but also confirms their competence/skills.…”