Entrustable Professional Activities in Psychiatry: A Systematic Review

Pinilla, Severin; Lenouvel, Eric; Strik, Werner; Klöppel, Stefan; Nissen, Christoph; Huwendiek, Sören

doi:10.1007/s40596-019-01142-7

Cited by 25 publications

(24 citation statements)

References 37 publications

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“…EPAs have been developed by other medical specialties such as pediatrics, internal medicine, surgery, psychiatry, and family medicine, among others. 1,[5][6][7][8][9][10][11][12] These EPAs are specific for each specialty or subspecialty but have common themes such as being able to provide consultation and competence in performing procedures and providing appropriate clinical care. Until recently, it was typical for just pathology/transfusion medicine and nephrology trainees to undergo apheresis rotations or demonstrate proficiency in apheresis procedures during their graduate or postgraduate medical education.…”

Section: Discussionmentioning

confidence: 99%

“…EPAs have been developed by other medical specialties such as pediatrics, internal medicine, surgery, psychiatry, and family medicine, among others 1,5–12 . These EPAs are specific for each specialty or subspecialty but have common themes such as being able to provide consultation and competence in performing procedures and providing appropriate clinical care.…”

Section: Discussionmentioning

confidence: 99%

“…4 Since then, EPAs have been developed for multiple specialties and subspecialties, including internal medicine, pediatrics, family practice, pathology, and subspecialties such as nephrology. 1,[5][6][7][8][9][10][11][12] Apheresis medicine (AM) is a specialty that focuses on the practice of donor and therapeutic apheresis. Unique to AM, medical oversight can be provided by multiple different specialties and/or subspecialties depending on the setting, for example, pathology/transfusion medicine, nephrology, or hematology.…”

Section: Introductionmentioning

confidence: 99%

“…He introduced certain EPA attributes: part of essential professional work; require knowledge, skill, and attitude; lead to recognized output; confined to qualified personnel; independently executable; and within a period, should be observable and should reflect one or more of the competencies to be acquired 4 . Since then, EPAs have been developed for multiple specialties and subspecialties, including internal medicine, pediatrics, family practice, pathology, and subspecialties such as nephrology 1,5–12 …”

Section: Introductionmentioning

confidence: 99%

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Entrustable professional activities for apheresis medicine education

et al. 2020

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Background: Entrustable professional activities (EPAs) are well-defined, executable, observable, and measurable activities that are performed by a trainee and can be performed independently as training progresses. The purpose of this study is to develop EPAs specific for the practice of apheresis medicine (AM). Methods: Members of the American Society for Apheresis Graduate Medical Education subcommittee developed a list of 28 apheresis medical activities linked to Accreditation Council for Graduate Medical Education milestones and competencies in five areas: (a) consultation, (b) clinical care for therapeutic apheresis, (c) clinical care for donor collections, (d) test optimization, and (e) vascular access. Ten AM experts using a validated tool to measure the quality of the EPAs (QUEPA) evaluated these activities with use of a Likert scale. Per group consensus, an activity was considered acceptable for each domain if it had received an average score greater than 3.7, and it was rated 4 or 5 (agree or strongly agree) by at least 70% of experts. Results: Of the 28 activities, 11 did not have acceptable QUEPA scores: 7 activities were rated as unobservable, 4 were rated unfocused, 2 were rated unrealistic and not generalizable, and 2 were rated as not addressing multiple competencies. Four activities had unacceptable scores in more than one domain. Subcommittee members edited these 11 activities over two review cycles to produce a final list of 26 activities. Conclusion: A set of practical, focused, and observable EPAs in AM were systematically developed. These EPAs can be used to assess and support trainee performance in AM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Entrustable professional activities for apheresis medicine education

et al. 2020

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“…The introduction of an EPA-based clinical curriculum typically involves informing students and staff about EPAs as learning goals, for implementation of new teaching activities, and in some cases for reforming workplace-based assessment instruments [ 10 – 12 ]. Observational studies on assessment of EPAs in psychiatry have revealed poor correlation of global performance assessments between student and supervisor ratings per core EPA.…”

mentioning

confidence: 99%

Introducing a Psychiatry Clerkship Curriculum Based on Entrustable Professional Activities: an Explorative Pilot Study

et al. 2021

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Objective The authors evaluated a reformed psychiatry clerkship curriculum based on entrustable professional activities (EPAs). Methods The authors conducted an exploratory pilot study of a reformed clerkship curriculum based on EPAs. A novel workplace-based assessment format including an entrustment-supervision scale and curricular adaptations were introduced. The Kirkpatrick model was used to evaluate outcomes of the reformed clerkship curriculum on three levels (1 = acceptance, 2 = learning, 3 = change of behavior). Results The pilot student cohort (n = 10) completed a questionnaire, 180 self-assessments (18 per student) on need for supervision, and 63 workplace-based assessments (6.3 per student, in 4 weeks). Level 1: high overall satisfaction with the clerkship (five-point Likert item: average, 4.9; range: 4.0–5.0). Level 2: the overall significant decrease in self-assessed need for supervision before and after the clerkship was two supervision levels (direct to indirect supervision; p < 0.05). The most frequently documented admissions included schizophrenic disorders (n = 11; 28%), affective disorders (n = 10; 25%), substance abuse disorders (n = 5; 13%), and anxiety and stress-related disorders (n = 5; 13%). Level 3: clinical supervisors used history taking, assessing the mental status, and documentation and presentation for workplace-based assessments. According to supervisors’ ratings, there was a decreasing need for supervision from the first to last week of the clerkship. Conclusions Students reacted positively to the reformed clerkship curriculum. The workplace-based assessments with entrustment ratings appeared to support achievement of competency-based learning objectives. Better understanding of how to cover assessment of all core EPAs in the psychiatry clerkship is needed.

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Trainee doctors' preparedness for clinical work in geriatric psychiatry: A survey on 18 preliminary entrustable professional activities

Lerch

Pinilla

Nendaz

et al. 2023

Int J Geriat Psychiatry

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Background:Research concerning transitions from one rotation to another during medical specialist training is scarce. This study examined trainee doctors' perceived preparedness for core clinical activities, trainee doctors' preparedness levels, and general perceptions of medical specialist training in geriatric psychiatry.Method: Swiss trainee doctors in geriatric psychiatry were surveyed about their perceived preparedness for 18 preliminary entrustable professional activities (EPAs), curricular support, and general perceptions of their medical specialist training. Closed questions were analysed using descriptive statistics, while open questions were subjected to content analysis. Results:The participants comprised 48 trainee doctors (30.4% response rate) who differed in their educational experience (years of residency and specialism) and clinical subspecialisation goals. Trainee doctors felt adequately prepared for most EPAs but less prepared for some, including electroconvulsive therapy, psychotherapy, and treating older adults in the home environment or residential facilities.Despite the trainee doctors' diversity, they did not differ significantly in perceived preparedness for most EPAs. The most often offered suggestions for improving geriatric psychiatry training were intensified clinical supervision and a structured induction programme. Conclusion:Trainee doctors reported that they felt sufficiently prepared for most EPAs, regardless of their backgrounds and professional goals. However, several professional activities in geriatric psychiatry warrant further training. Our findings indicate the need for a higher intensity of clinical supervision (e.g. more direct observation and specific feedback), the introduction of structured induction programmes (e.g. orientation week), and specific teachings (e.g. on neurocognitive assessment).This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Entrustable Professional Activities in Psychiatry: A Systematic Review

Cited by 25 publications

References 37 publications

Entrustable professional activities for apheresis medicine education

Entrustable professional activities for apheresis medicine education

Introducing a Psychiatry Clerkship Curriculum Based on Entrustable Professional Activities: an Explorative Pilot Study

Trainee doctors' preparedness for clinical work in geriatric psychiatry: A survey on 18 preliminary entrustable professional activities

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