Abstract:Background A residency program's intern cohort is comprised of individuals from different medical schools that place varying levels of emphasis on Core Entrustable Professional Activities for Entering Residency (CEPAERs). Program directors have expressed concerns about the preparedness of medical school graduates. Though guiding principles for implementation of the CEPAERs have been published, studies using this framework to assess interns' baseline skills during orientation are limited.Objective A CEPAER-base… Show more
“…In a study, 89% of interns claimed that they would make a change according to EPAs feedback in their next consultation request[ 28 ]. Similar evidence is provided by two other studies: in the first one, participants agreed that EPAs met the defined criteria and were considered important for graduates to be able to demonstrate the expected behaviors[ 32 ]; in the second one, the majority of the physicians agreed that the assessment based on EPAs was meaningful, and immediate feedback was beneficial[ 15 ]. Another 3-year longitudinal study claims that EPAs serve as an effective channel for communicating expectations to resident participants[ 20 ].…”
Section: Resultsmentioning
confidence: 55%
“…Compared with previous 7 year[ 9 ], the proportion of teaching sessions in programs risen from 17% to 24.1%, while the ratio of curriculums decreased from 33% to 17.2%, shown a tendency that more and more EPAs being implemented or assessed directly rather than insert into curriculums. Besides, two studies attempt to assess participants’ EPA levels by implementing objective structured clinical examination (OSCE) [ 14 , 15 ], which provide a new prospective for combining EPAs with existing assessment frameworks. Figure 2.…”
The purpose of this scoping review is to update the recent progress of EPAs research in GME, focusing on the topical concern of EPAs effectiveness, and to provide a reference for medical researchers in countries/regions interested in introducing EPAs. Guided by Arksey and O’Malley’s framework regarding scoping reviews, the researchers, in January 2021, conducted a search in five databases to ensure the comprehensiveness of the literature. After the predetermined process, 29 articles in total were included in this study. The most common areas for the implementation and evaluation of EPAs were Surgery (n = 7,24.1%), Pediatric (n = 5,17.2%) and Internal medicine (n = 4,13.8%), a result that shows a relatively large change in the research trend of EPAs in the last two years. Prior to 2018, EPAs research focused on internal medicine, psychiatry, family medicine, and primary care. The articles in the category of EPAs implementation and evaluation had four main themes: (1) validation of EPAs (n = 16,55.2%); (2) describing the experience of implementing EPAs (n = 11,37.9%); (3) examining the factors and barriers that influence the implementation and evaluation of EPAs (n = 6,20.6%); and (4) researching the experiences of faculty, interns, and other relevant personnel in using EPAs. Training programs were the most common EPAs implementation setting (n = 26,89.6%); direct observation and evaluation (n = 12,41.4%), and evaluation by scoring reports (n = 5,17.2%) were the two most common means of assessing physicians’ EPA levels; 19 papers (65.5%) used faculty evaluation, and nine of these papers also used self-assessment (31.0%); the most frequently used tools in the evaluation of EPAs were mainly researcher-made instruments (n = 37.9%), assessment form (n = 7,24.1%), and mobile application (n = 6,20.7%). Although EPAs occupy an increasingly important place in international medical education, this study concludes that the implementation and diffusion of EPAs on a larger scale is still difficult.
“…In a study, 89% of interns claimed that they would make a change according to EPAs feedback in their next consultation request[ 28 ]. Similar evidence is provided by two other studies: in the first one, participants agreed that EPAs met the defined criteria and were considered important for graduates to be able to demonstrate the expected behaviors[ 32 ]; in the second one, the majority of the physicians agreed that the assessment based on EPAs was meaningful, and immediate feedback was beneficial[ 15 ]. Another 3-year longitudinal study claims that EPAs serve as an effective channel for communicating expectations to resident participants[ 20 ].…”
Section: Resultsmentioning
confidence: 55%
“…Compared with previous 7 year[ 9 ], the proportion of teaching sessions in programs risen from 17% to 24.1%, while the ratio of curriculums decreased from 33% to 17.2%, shown a tendency that more and more EPAs being implemented or assessed directly rather than insert into curriculums. Besides, two studies attempt to assess participants’ EPA levels by implementing objective structured clinical examination (OSCE) [ 14 , 15 ], which provide a new prospective for combining EPAs with existing assessment frameworks. Figure 2.…”
The purpose of this scoping review is to update the recent progress of EPAs research in GME, focusing on the topical concern of EPAs effectiveness, and to provide a reference for medical researchers in countries/regions interested in introducing EPAs. Guided by Arksey and O’Malley’s framework regarding scoping reviews, the researchers, in January 2021, conducted a search in five databases to ensure the comprehensiveness of the literature. After the predetermined process, 29 articles in total were included in this study. The most common areas for the implementation and evaluation of EPAs were Surgery (n = 7,24.1%), Pediatric (n = 5,17.2%) and Internal medicine (n = 4,13.8%), a result that shows a relatively large change in the research trend of EPAs in the last two years. Prior to 2018, EPAs research focused on internal medicine, psychiatry, family medicine, and primary care. The articles in the category of EPAs implementation and evaluation had four main themes: (1) validation of EPAs (n = 16,55.2%); (2) describing the experience of implementing EPAs (n = 11,37.9%); (3) examining the factors and barriers that influence the implementation and evaluation of EPAs (n = 6,20.6%); and (4) researching the experiences of faculty, interns, and other relevant personnel in using EPAs. Training programs were the most common EPAs implementation setting (n = 26,89.6%); direct observation and evaluation (n = 12,41.4%), and evaluation by scoring reports (n = 5,17.2%) were the two most common means of assessing physicians’ EPA levels; 19 papers (65.5%) used faculty evaluation, and nine of these papers also used self-assessment (31.0%); the most frequently used tools in the evaluation of EPAs were mainly researcher-made instruments (n = 37.9%), assessment form (n = 7,24.1%), and mobile application (n = 6,20.7%). Although EPAs occupy an increasingly important place in international medical education, this study concludes that the implementation and diffusion of EPAs on a larger scale is still difficult.
“…Ethical Approval The University of Pittsburgh Institutional Review Board (IRB #2003005) determined that this study is exempt. Depression/anxiety 1 (1) n, number of interns who circled this response. Interns were asked to circle three topics they felt were most important…”
Section: Compliance With Ethical Standardsmentioning
confidence: 99%
“…Several studies suggest that incoming interns lack clinical and professional skills that residency program directors expect interns to have mastered during medical school [1][2][3][4][5]. Over the last decade, medical educators have created residency preparatory courses (boot camps) to bolster the skills of fourth-year medical students (MS4s) about to enter residency.…”
In the last decade, boot camp residency preparatory courses for fourth-year medical students have become increasingly popular in medical schools across the USA; however, the curricular content of these courses varies widely. The authors surveyed internal medicine interns at a large academic medical center regarding clinical and non-clinical topics that would be useful for an internal medicine residency preparatory curriculum. The response rate was 79% (64/81). A rational approach to antibiotics (42%) and electrolyte management (41%) were the most frequent clinical topics and cross-cover (69%) was the most frequent non-clinical topic selected by interns.
“…Many studies have reported that CPAs using SPs, such as the OSCE, are reliable and valid to evaluate the clinical performance of healthcare students, and allow examiners to provide more accurate feedback to students [28][29][30][31][32][33][34]. However, an issue for CPAs is the possible subjectivity of examiners that may introduce the risk of unfairness and bias, especially when examiners are affected by construct-irrelevant characteristics, such as ethnicity and/or gender [3,[35][36][37].…”
Background: Several forms of bias, including ethnic and gender bias, are thought to impact evaluations on Clinical Performance Assessments (CPAs). Unfairness may influence student learning attitudes if a loss of trust causes a lack of engagement in learning. Understanding the biases occurring in CPAs can lead to well-designed examiner training to ensure equality and fairness. The purpose of this systematic review is to determine the current evidence in the literature for ethnic and/or gender bias by examiners evaluating pre-licensure healthcare students in CPAs using standardized patients (SPs). Methods: Literature was systematically searched in CINAHL, PubMed and Medline from inception to February 2019, and no date range was set. Studies related to the investigation of ethnic and/or gender biases occurring in CPAs using SPs for examining health professions students were selected. A systematic review was conducted to assess the methodological quality and strength of evidence of relevant research and to identify if any potential ethnic and/or gender bias occurred in CPAs. The Guidelines for Critical Review were used to appraise the selected studies. Results: Nine studies published from 2003 to 2017 were retrieved for review. Three studies met all the Guidelines for Critical Review quality criteria, indicating stronger evidence of their outcomes, two of the studies reported ethnic and/or gender bias existing in the CPAs. Overall, four studies found ethnic and/or gender bias in CPAs, but all study results had small effect sizes. Conclusions: No systematic and consistent bias was found across the studies; nonetheless, the possibility of ethnic or gender bias by some examiners cannot be ignored. To minimize potential examiner bias, the investigation of Frame of Reference training, multiple examiners per station, and combination assessments in CPAs is recommended.
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