What are we preparing them for? Development of an inventory of tasks for medical, surgical and supportive specialties

Abstract

Background: Internationally, postgraduate medical education (PGME) has shifted to competency-based training. To evaluate the effects of this shift on the outcomes of PGME appropriate instruments are needed. Aim: To provide an inventory of tasks specialists perform in practice, which can be used as an instrument to evaluate the outcomes of PGME across disciplines. Methods: Following methodology from job analysis in human resource management, we used document analyses, observations, interviews and questionnaires. Two thousand seven hundred and twenty eight specialists were then asked to indicate how frequently they performed each task in the inventory, and to suggest additional tasks. Face and content validity was evaluated using interviews and the questionnaire. Tasks with similar content were combined in a total of 12 clusters. Internal consistency was evaluated by calculating Cronbach's alpha. Construct validity was determined by examining predefined differences in task performance between medical, surgical and supportive disciplines. Results: Seven hundred and six specialists (36%) returned the questionnaire. The resulting inventory of 91 tasks showed adequate face and content validity. Internal consistency of clusters of tasks was adequate. Significant differences in task performance between medical, surgical and supportive disciplines indicated construct validity. Conclusion: We established a comprehensive, generic and valid inventory of tasks of specialists which appears to be applicable across medical, surgical and supportive disciplines.

Preparedness for practice: A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

“…Although most clusters contain some tasks which can be relevant for multiple specialties, we reasoned that at cluster level not all comparisons would be equally meaningful. In line with previous work (Dijkstra et al 2013), we assumed that specialists in surgical and medical disciplines perform tasks directly related to patient care more frequently compared to specialists in supportive disciplines. Therefore, we only compared the scores of surgical and medical specialist on the clusters that relate most directly to patient care (Box 1, clusters 1-6).…”

“…For this study, we used a generic inventory of 91 medical specialist tasks divided into 12 clusters of similar content that we developed previously (Dijkstra et al 2013) (Box 1). For each task, respondents were asked to rate their agreement to the statement: ''my training program prepared me well for.…”

“…For PGME, however, no such inventory exists. To be able to systematically study how well new consultants feel prepared for practice, we developed a comprehensive and cross-specialty applicable task inventory (Dijkstra et al 2013). In the present study, we used this inventory to examine across specialties for which tasks of independent practice new consultants feel insufficiently prepared.…”

Small Group Tutorials in Radiology: a Pilot Study

“…This raises the question as to whether one can improve the underlying teaching methods so that doctors can be more dynamic and resilient practitioners from an early stage 3,4 . It is clear that there is a misalignment between the medical education continuum and preparedness for practice 5 . This research aimed to bridge the gap with the addition of small group Radiology tutorials to the standard lecture-based curriculum in a bid to enhance the learning experience and make junior doctors more fluid in the clinical arena.…”

Trusting Graduates to Enter Residency: What Does It Take?

“…[7][8][9] However, looking at what exactly residents are expected to do safely from the first day of training has not been the general method, although some have used this approach for graduate medical education. 10 The Association of American Medical Colleges has produced a draft document called ''Core Entrustable Professional Activities for Entering Residency'' (CEPAER), describing 13 EPAs that medical graduates should have attained at a level that permits practice without direct supervision (T A B L E). 11 Medical trainees should be able to carry out these activities without direct supervision from the first day of residency.…”