Constructing a Shared Mental Model for Faculty Development for the Core Entrustable Professional Activities for Entering Residency

Abstract

In 2014, the Association of American Medical Colleges identified 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs), which are activities that entering residents might be expected to perform without direct supervision. This work included the creation of an interinstitutional concept group focused on faculty development efforts, as the processes and tools for teaching and assessing entrustability in undergraduate medical education (UME) are still evolving. In this article, the authors describe a conceptual framework for entrustment that they developed to better prepare all educators involved in entrustment decision making in UME. This framework applies to faculty with limited or longitudinal contact with medical students and to those who contribute to entrustment development or render summative entrustment decisions.The authors describe a shared mental model for entrustment that they developed, based on a critical synthesis of the EPA literature, to serve as a guide for UME faculty development efforts. This model includes four dimensions for Core EPA faculty development: (1) observation skills in authentic settings (workplace-based assessments), (2) coaching and feedback skills, (3) self-assessment and reflection skills, and (4) peer guidance skills developed through a community of practice. These dimensions form a conceptual foundation for meaningful faculty participation in entrustment decision making.The authors also differentiate between the UME learning environment and the graduate medical education learning environment to highlight distinct challenges and opportunities for faculty development in UME settings. They conclude with recommendations and research questions for future Core EPA faculty development efforts.

Entrustable professional activities in health care education: a scoping review

“…Four papers emphasised the necessity for the implementation of EPAs for the teaching faculty staff, specifically undergraduate medical education (UME) educators, surgical simulation leaders and residency programme directors, in order to ensure and assess their competencies. Specific EPAs with varying complexities were proposed to better match the responsibilities and competencies of different faculty members, specifically in UME and GME.…”

“…Specific EPAs with varying complexities were proposed to better match the responsibilities and competencies of different faculty members, specifically in UME and GME. Other studies proceeded to develop and identify 12 EPAs for faculty members, propose a shared mental model for entrustment, and provide an example on linking competencies with EPAs for instructors …”

“…Moreover, because of the lack of required demonstration of competency for faculty staff and the inefficiency of current staff training, few studies believed that it is vital to develop a specific set of EPAs for faculty members and educators before they conduct EPA‐based curricula with trainees . This can better inform entrustment decisions for professional activities, increase the involvement of stakeholders and promote trust building within the faculty hierarchy . Similar to the trickle‐down approach in economics, the advantages of EPA‐based faculty training and faculty competency assessments will trickle down to benefit the entire educational system .…”

Entrustable Professional Activity Utilization: A CERA Study of Family Medicine Residency Program Directors

“…15 Faculty development may be simpler for EPAs in GME because EPAs are based on clinical descriptions where faculty are well versed, in place of abstract educational outcomes or milestones. [16][17][18] EPAs as an assessment framework will require more faculty time through increased direct observations of learners, which will enhance reliability and validity of assessment. 19 Future inquiries regarding learner and faculty outcomes, such as level of competency or faculty ability to provide feedback, would add to understanding potential outcomes of EPA utilization.…”

Tempo do Brasil traduzir para a prática o currículo Médico Baseado em Competência por meio de Atividades Profissionais Confiáveis (APCs)

“…Since 2005, the concept and application of EPAs, initially proposed for postgraduate studies, has emerged as new and more promising approach in the CBME's materialization in medical graduation, decoding it, in daily practice, in effective and safe medical care 15,34,[36][37][38]44,45 .…”