National consensus on entrustable professional activities for competency-based training in anaesthesiology

Abstract

Entrustable Professional Activities (EPA) are specialty specific tasks or responsibilities, combining the clinical workplace and the long-demanded competency-based medical education. The first step to transform time-based into EPA-based training is to reach consensus on core EPAs that describe sufficiently the workplace. We aimed to present a nationally validated EPA-based curriculum for postgraduate training in anaesthesiology. Using a predefined and validated list of EPAs, we applied a Delphi consensus approach, involving all German chair directors of anaesthesiology. We then conducted a subsequent qualitative analysis. Thirty-four chair directors participated in the Delphi survey (77% response) and twenty-five completed all the questions (56% overall response). Reflected by the intra-class-correlation, the consensus on the importance (ICC: 0.781, 95% CI [0.671, 0.868]) and the year of entrustment (ICC: 0.973, 95% CI [0.959, 0.984]) of each EPA reached high levels of agreement among the chair directors. The comparison of data assessed in the preceding validation and present study showed excellent and good levels of agreement (ICC entrustment: 0.955, 95% CI [0.902, 0.978]; ICC importance: 0.671, 95% CI [-0.204, 0.888]). The adaptation process, based on the qualitative analysis, resulted in a final set of 34 EPAs. We present an elaborate, fully described and nationally validated EPA-based curriculum, reflecting a broad consensus among different stakeholders of anaesthesiology. We hereby provide a further step towards competency-based postgraduate anaesthesiology training.

Teaching regional anesthesia: current perspectives

“…The emergence of Entrustable Professional Activities (EPAs) has led to a call for change in medical and health profession curricula. EPAs are units of clinical practice, Advances in Regional Anesthesia -Future Directions in the Use of Regional Anesthesia tasks, or responsibilities that students can perform without supervision once they have achieved the desired competency [28,[63][64][65]. Each EPA incorporates domains and subdomains of general competencies, integrated with specific content from the curriculum's educational programs.…”

“…Each EPA incorporates domains and subdomains of general competencies, integrated with specific content from the curriculum's educational programs. Didactic activities are designed from concrete daily experiences in clinical practice at different levels depending on the year of study [28,64,65]. Three strategies, namely, situated learning, deliberate practice, and reflection, are used to help students achieve reliable clinical activities [66].…”

Indigenizing and co-producing the ACGME anesthesiology milestone in Taiwan: a Delphi study and subgroup analysis

“…The Anesthesiology Milestone Project, initiated conjointly by the ACGME and the American Board of Anesthesiology, has been officially implemented in all the residency training programs in the United States since 2015 [ 4 ]. To adopt the CBME conceptual model crossculturally in a foreign clinical and educational system, the indigenizing process such as mixed method exploratory triangulation [ 5 , 6 ], back-translation [ 7 ], or two-step validation [ 8 , 9 ] were borrowed. Indigenization, in the context of document translation, refers to the process of adapting a document to the cultural and linguistic context of an “indigenous” community.…”

“…Expert committee translation may ensure content accuracy and prevent cultural loss in the local context during CBME adoption [ 11 ]. Second, the co-production model of healthcare and its education, which values patients’ and learners’ engagement, was urged nowadays to facilitate sustainability and desired outcomes [ 5 , 6 , 8 , 12 ]. Such a conceptual model could be applied to a consensus study by deliberately recruiting different categories of key stakeholders [ 8 , 13 , 14 ].…”

“…Second, the co-production model of healthcare and its education, which values patients’ and learners’ engagement, was urged nowadays to facilitate sustainability and desired outcomes [ 5 , 6 , 8 , 12 ]. Such a conceptual model could be applied to a consensus study by deliberately recruiting different categories of key stakeholders [ 8 , 13 , 14 ]. Considering the junior members’ perspectives is essential to meeting the learners’ needs.…”