The New Internal Medicine Subinternship Curriculum Guide: a Report from the Alliance for Academic Internal Medicine

Vu, T. Robert; Ferris, Allison; Sweet, Michelle; Angus, Steven V.; Ismail, Nadia; Stewart, Emily; Appelbaum, Jonathan; Kwan, Brian

doi:10.1007/s11606-019-04957-0

Cited by 21 publications

(9 citation statements)

References 37 publications

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“…Examples include "Evaluation of patients with respiratory insufficiency" [18] or "Gather a medical history, perform a physical exam and provide a structured summary of the results" [20]. Educators adjusted either nested or specifically developed EPAs for their local clinical rotation context [22][23][24][25][26]. All of these subsets had fewer EPAs in comparison to the national EPA-frameworks in UME.…”

Section: Epa Development For Clinical Rotations In Umementioning

confidence: 99%

“…To implement EPA-based curricula across institutions, we see a need for a more consequential use of published EPA templates [59] that would allow for the transfer of successful implementation strategies. Furthermore, it might be challenging to effectively implement EPA-based clinical curricula together with teaching additional core skills such as time-management skills and personal well-being in clinical workplaces within 4 weeks [26]. Therefore, an integrated longitudinal clerkship curriculum design might offer more opportunities to accommodate these personal development objectives [36].…”

Section: Epa-based Curriculum Implementationmentioning

confidence: 99%

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Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

et al. 2021

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Background Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. Methods We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. Results We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. Conclusions There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.

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Section: Epa Development For Clinical Rotations In Umementioning

confidence: 99%

Section: Epa-based Curriculum Implementationmentioning

confidence: 99%

Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

et al. 2021

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“…Teaching session topics were aligned with the nationally recognized subinternship curriculum published by the Clerkship Directors in Internal Medicine (CDIM). 4 The pedagogical approach for individual sessions was at the discretion of the instructor but was generally case-based and interactive; some sessions involved prework (such as reviewing electrocardiograms before a session). The students also attended the internal medicine residency program’s morning report sessions, which are designed to help residents and students practice clinical reasoning and review the diagnosis and management of common diseases in internal medicine.…”

Section: Approachmentioning

confidence: 99%

Development of a Single-Institution Virtual Internal Medicine Subinternship With Near-Peer Teaching in Response to the COVID-19 Pandemic

et al. 2021

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“…Entrustment denotes competency in specific professional activities that can be carried out without direct supervision on day one of residency [ 1 ]. It has been suggested that EPAs be incorporated into teaching in the fourth year (MS4), but formative assessment that begins earlier in clinical training allows for opportunities for feedback and improvement before entrustment decisions are made [ 2 - 7 ]. While EPA assessment should ideally occur in real-time clinical settings, work-place based assessment of some EPAs is often not feasible, and sometimes not ethical.…”

Section: Introductionmentioning

confidence: 99%

Simulation as a Platform for Development of Entrustable Professional Activities: A Modular, Longitudinal Approach

Herrigel¹,

Donovan²,

Goodman³

et al. 2020

Cureus

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Background The Association of American Medical Colleges (AAMC) has recently identified a list of integrated activities to be expected of all medical school graduates entering residency: the core Entrustable Professional Activities (EPAs). Direct observation and deliberate practice of individual EPA behaviors in the clinical setting has multiple challenges, and there is limited literature describing a comprehensive, longitudinal curriculum dedicated to formative EPA assessment. Approach We present a model curriculum to develop and provide formative assessment of EPA skills longitudinally throughout the clinical years. Each EPA-focused training session includes a simulation case followed by several small group activities with content related to the clinical vignette in the initial simulation. We have designed this curriculum to be longitudinal and modular, and present the general framework here. Outcomes Step-wise implementation began in 2013. Over 450 medical students have participated in the third year (MS3) clerkship sessions, 30 in the MS4 sub-internship sessions, and over 300 thus far in the fourth year (MS4) capstone course, including students from 10 different medical schools. MS3 sessions focused on EPAs 4, 7, 8, 9, 10, and MS4 sessions had an additional focus on EPA 8. The capstone course encompassed nearly all 13 EPAs in active simulation-based learning. Opportunities to provide formative assessment through onthe-spot feedback exist throughout the curriculum. Student feedback was overwhelmingly positive. Next steps We found that simulations are an effective method of providing formative assessment of EPAs that are exceptionally well-received by medical students. We have demonstrated that these can be implemented for medical students from multiple educational backgrounds. We believe that deliberate practice and longitudinal formative assessment is of utmost importance in effectively developing core EPAs prior to final entrustment decisions.

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The New Internal Medicine Subinternship Curriculum Guide: a Report from the Alliance for Academic Internal Medicine

Cited by 21 publications

References 37 publications

Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

Development of a Single-Institution Virtual Internal Medicine Subinternship With Near-Peer Teaching in Response to the COVID-19 Pandemic

Simulation as a Platform for Development of Entrustable Professional Activities: A Modular, Longitudinal Approach

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