Introducing a competency based Fellowship programme for psychiatry in Australia and New Zealand

Purpose This review aimed to synthesise some of the extant work on the use of entrustable professional activities (EPAs) for postgraduate physicians, to assess the quality of the work and provide direction for future research and practice. Method Systematic searches were conducted within five electronic databases (Medline, Scopus, Web of Science, PsycINFO and CINAHL) in September 2018. Reference lists, Google Scholar and Google were also searched. Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results In total, 49 studies were included, classified as Development of EPAs (n = 37; 76% of total included), Implementation and/or assessment of EPAs (n = 10; 20%), or both (n = 2; 4%). EPAs were described for numerous specialties, including internal medicine (n = 14; 36%), paediatrics (n = 8; 21%) and psychiatry (n = 4; 10%). Of the development studies, 92% utilised more than one method to generate EPAs. The two most commonly used methods were developing initial EPAs in a working group, (n = 27; 69%) and revising through deliberation (n = 21; 54%). Development papers were of variable quality (mean QATSDD score = 20, range 6–41). Implementation and assessment studies utilised methods that included observing trainee performance (n = 6; 50%) and enrolling trainees in competency‐based curricula, which included EPAs (n = 4; 33%). The methodological quality of these implementation studies varied (mean QATSDD score = 19.5, range = 6–32). Conclusions This review highlighted a need for: (i) consideration of best practice guidelines for EPA development; (ii) focus on the methodological quality of research on EPA development and of EPAs, and (iii) further work investigating the implementation of EPAs in the curriculum.

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“…A total of 2894 records were screened, with 49 articles deemed eligible for inclusion (for PRISMA diagram, see Fig. ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011–2018

et al. 2019

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“…This, however, is typical practice among current reports of EPA development, with EPAs developed across several countries including The Netherlands, New Zealand, and Australia [18,37]. The EPAs developed by these other countries were also designed to be implemented at different stages of medical training, compared to the Irish Intern EPAs [18,37]. Further, as the intern year in the Republic of Ireland is unique in terms of structure and duration, and also custom and practice within Irish training hospitals, it was considered appropriate to develop a framework of EPAs that reflected the work of interns in Ireland, albeit aligned with the AAMC Core EPAs [25].…”

Section: Limitationsmentioning

confidence: 99%

“…Developing country-specific EPAs could limit their generalisability to international systems and in turn hinder physicians who wish to work outside of Ireland. This, however, is typical practice among current reports of EPA development, with EPAs developed across several countries including The Netherlands, New Zealand, and Australia [18,37]. The EPAs developed by these other countries were also designed to be implemented at different stages of medical training, compared to the Irish Intern EPAs [18,37].…”

Section: Limitationsmentioning

confidence: 99%

The development of a framework of entrustable professional activities for the intern year in Ireland

et al. 2020

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Background: Entrustable Professional Activities (EPAs) are units of professional practice that capture essential competencies in which trainees must become proficient before undertaking them independently. EPAs provide supervisors with a solid justification for delegating an activity to trainees. This study aimed to develop and ensure face validity of a set of EPAs for junior doctors in the first year of clinical practice in the Republic of Ireland. Methods: An iterative eight stage consensus building process was used to develop the set of EPAs. This process was based on international best practice recommendations for EPA development. A series of surveys and workshops with stakeholders was used to develop a framework of EPAs and associated competencies. An external stakeholder consultation survey was then conducted by the Irish Medical Council. The framework of EPAs was then benchmarked against the 13 core EPAs developed by the Association of American Medical Colleges (AAMC). Results: A framework of seven EPAs, and associated competencies resulted from this study. These EPAs address all core activities that junior doctors should be readily entrusted with at the end of the intern year, which is the first year of clinical practice in the Republic of Ireland. Each EPA contains a series of defined competencies. The final EPAs were found to be comparable to the AAMC core EPAs for entering residency. Conclusions: A framework of EPAs for interns in Ireland that are appropriate for the intern year has been developed by key stakeholders. The implementation of the EPAs in practice is the next step, and is likely to result in an improved intern training process and increased patient safety.

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“…1,2 The expectation to produce a dissertation is not new; it was a requirement removed with the introduction of the 2003 iteration of the training program. 3 A renewed emphasis on research is consistent with the CanMEDS framework around which the CBFP is structured, 2,4,5 and supported by the assertion that research skills will improve the clinical practice of psychiatrists. 1,2,5 In discussing the importance of fostering a research culture within psychiatry, Professor Stephen Kisely, a clinician-researcher and the Statistical Editor of Australasian Psychiatry, made the impassioned plea for the "next generation of clinician scientists… [to] please step forward".…”

mentioning

confidence: 97%

Stepping forward: challenges and pathways to building a vibrant research culture through the Scholarly Project

Ayres

Suetani

et al. 2018

Australas Psychiatry

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Objectives: The Scholarly Project is a relevant task to support building a culture of research in psychiatry across Australia and New Zealand. However, there are several impediments to trainees’ confident completion of this project. The authors review recent literature on the challenges voiced by trainees, as well as solutions posed by clinician-researchers and medical educators. Relevant strategies are highlighted, and several practical solutions to support the completion of the Scholarly Project are proposed. Conclusions: There are several pathways available to alleviate barriers to trainees’ timely commencement and completion of the Scholarly Project, including enhancing research capacity within services, familiarity with the requirements, access to supervisors and additional support for trainees.

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Introducing a competency based Fellowship programme for psychiatry in Australia and New Zealand

Cited by 22 publications

References 18 publications

A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011–2018

A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011–2018

The development of a framework of entrustable professional activities for the intern year in Ireland

Stepping forward: challenges and pathways to building a vibrant research culture through the Scholarly Project

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