Frameworks for learner assessment in medicine: AMEE Guide No. 78

Pangaro, Louis N.; Cate, Olle ten

doi:10.3109/0142159x.2013.788789

Cited by 165 publications

(127 citation statements)

References 47 publications

(57 reference statements)

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“…9,11 EPAs operationalize medical education outcomes as essential professional activities that one entrusts a professional to perform. 12 An example of such an activity is "care of complicated pregnancies." 5 Each EPA is a synthesis of multiple competency domains (e.g., medical knowledge, communication skills, and professionalism) and requires the integration of knowledge, skills, and attitudes.…”

Section: Perspectivementioning

confidence: 99%

“…5 Each EPA is a synthesis of multiple competency domains (e.g., medical knowledge, communication skills, and professionalism) and requires the integration of knowledge, skills, and attitudes. 12 Whereas traditional Abstract Many graduate medical education (GME) programs have started to consider and adopt entrustable professional activities (EPAs) in their competency frameworks. Do EPAs also have a place in undergraduate medical education (UME)?…”

Section: Perspectivementioning

confidence: 99%

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The Case for Use of Entrustable Professional Activities in Undergraduate Medical Education

2015

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Many graduate medical education (GME) programs have started to consider and adopt entrustable professional activities (EPAs) in their competency frameworks. Do EPAs also have a place in undergraduate medical education (UME)? In this Perspective article, the authors discuss arguments in favor of the use of EPAs in UME. A competency framework that aligns UME and GME outcome expectations would allow for better integration across the educational continuum. The EPA approach would be consistent with what is known about progressive skill development. The key principles underlying EPAs, workplace learning and trust, are generalizable and would also be applicable to UME learners. Lastly, EPAs could increase transparency in the workplace regarding student abilities and help ensure safe and quality patient care. The authors also outline what UME EPAs might look like, suggesting core, specialty-specific, and elective EPAs related to core clinical residency entry expectations and learner interest. UME EPAs would be defined as essential health care activities with which one would expect to entrust a resident at the beginning of residency to perform without direct supervision. Finally, the authors recommend a refinement and expansion of the entrustment and supervision scale previously developed for GME to better incorporate the supervision expectations for UME learners. They suggest that EPAs could be operationalized for UME if UME-specific EPAs were developed and the entrustment scale were expanded.

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Section: Perspectivementioning

confidence: 99%

Section: Perspectivementioning

confidence: 99%

The Case for Use of Entrustable Professional Activities in Undergraduate Medical Education

2015

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“…Learners must consider and design their response rather than recall the correct answer (Linn & Miller, 2005). This also allows direct assessment of other cognitive skills, critical analysis skills, information literacy and writing skills (Pangaro & ten Cate, 2013). We believe that feedback is required even if there are no concerns to be addressed, the coursework was well done and there are no needs for any further improvement 'everything is OK'.…”

Section: Methodsmentioning

confidence: 99%

Distance Learning in Clinical Transplantation: A Successful Model in Post-Graduate Education

Halawa

Sharma²,

Bridson

et al. 2017

WJE

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Background and Purpose: There are misconceptions among clinicians and educational bodies that online courses would not suit clinically orientated medical education, where bedside management and direct contact with real patients is the key to the learning process. Whereas, the proponents of online education believe that a well-designed and properly blueprinted course can deliver the required education that would efficiently meet the expectations of both the student and these educational bodies. While variations in medical practice are a norm that warrant a flexible and, at the same time, a focused approach is required to ensure that 'threshold concepts' are learnt, which is an additional challenge. We aimed to facilitate the students to develop skills of learning from work-based reflective practice by linking with their own real-time analysis of their own clinical experience. This is supported by a robust scientific basis, a unique opportunity for many clinicians who may not have a reliable opportunity for discussion and, thereby, this course (MSc in Transplantation) provides a platform that allows everyone to learn from each other's experience by using 'e-blackboard ® '.Methods: Not just a knowledge transfer, the critical thresholds of each and every chapter in the 4 modules of MSc in Transplantation Sciences were defined to a razor-sharp precision. Learning objectives of learning activity were aimed to achieve constructive alignment with critical threshold. We employed Kirkpatrick pyramid (satisfaction, learning, impact, results and return on investment) (a) for the evaluation of our performance as educators of the programme, and (b) to evaluate the acceptance of this non-traditional format in clinical medicine education by postgraduate students (80 transplant clinicians from 22 countries).Results: Students' survey of the first cohort (satisfaction, Kirkpatrick level 1) reported 93% students' satisfaction rate. 93% of the students passed module one (learning Kirkpatrick level 2) and 100% subscription to module two (return on investment Kirkpatrick level 5). Conclusion:For a successful model in distance learning in clinical medicine it is imperative to establish an effective supportive contact using a range of modalities in order to allow real-time reflective practice that is so crucial in enabling the students to learn from their own clinical experience.

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“…10 The RIME framework is a well-established framework (model) 5,11 and it maps to both the Accreditation Council for Graduate Medical Education (ACGME) competency framework 12 and to entrustable professional activities (EPAs). 13 RIME is a synthetic framework; success at each level requires that a trainee demonstrate the integration of necessary knowledge, skills, and attitudes. 5 For example, to be a successful Reporter, a trainee must reliably, honestly, and accurately gather and communicate information about a patient in both spoken and written formats, and must engage with patients, families, and members of the healthcare team in the setting of real patient care.…”

Section: Introductionmentioning

confidence: 99%

Regular Formal Evaluation Sessions are Effective as Frame-of-Reference Training for Faculty Evaluators of Clerkship Medical Students

Hemmer

Dadekian²,

Terndrup

et al. 2015

J GEN INTERN MED

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BACKGROUND: Face-to-face formal evaluation sessions between clerkship directors and faculty can facilitate the collection of trainee performance data and provide frame-of-reference training for faculty. OBJECTIVE: We hypothesized that ambulatory faculty who attended evaluation sessions at least once in an academic year (attendees) would use the Reporter-Interpreter-Manager/Educator (RIME) terminology more appropriately than faculty who did not attend evaluation sessions (non-attendees). DESIGN: Investigators conducted a retrospective cohort study using the narrative assessments of ambulatory internal medicine clerkship students during the 2008-2009 academic year. PARTICIPANTS: The study included assessments of 49 clerkship medical students, which comprised 293 individual teacher narratives. MAIN MEASURES: Single-teacher written and transcribed verbal comments about student performance were masked and reviewed by a panel of experts who, by consensus, (1) determined whether RIME was used, (2) counted the number of RIME utterances, and (3) assigned a grade based on the comments. Analysis included descriptive statistics and Pearson correlation coefficients. KEY RESULTS: The authors reviewed 293 individual teacher narratives regarding the performance of 49 students. Attendees explicitly used RIME more frequently than non-attendees (69.8 vs. 40.4 %; p< 0.0001). Grades recommended by attendees correlated more strongly with grades assigned by experts than grades recommended by non-attendees (r=0.72; 95 % CI (0.65, 0.78) vs. 0.47; 95 % CI (0.26, 0.64); p= 0.005). Grade recommendations from individual attendees and non-attendees each correlated significantly with overall student clerkship clinical performance [r=0.63; 95 % CI (0.54, 0.71) vs. 0.52 (0.36, 0.66), respectively], although the difference between the groups was not statistically significant (p=0.21). CONCLUSIONS: On an ambulatory clerkship, teachers who attended evaluation sessions used RIME terminology more frequently and provided more accurate grade recommendations than teachers who did not attend. Formal evaluation sessions may provide frame-of-reference training for the RIME framework, a method that improves the validity and reliability of workplace assessment.

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Frameworks for learner assessment in medicine: AMEE Guide No. 78

Cited by 165 publications

References 47 publications

The Case for Use of Entrustable Professional Activities in Undergraduate Medical Education

The Case for Use of Entrustable Professional Activities in Undergraduate Medical Education

Distance Learning in Clinical Transplantation: A Successful Model in Post-Graduate Education

Regular Formal Evaluation Sessions are Effective as Frame-of-Reference Training for Faculty Evaluators of Clerkship Medical Students

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