Internal Medicine Residency Program Directors’ Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum

Angus, Steven V.; Vu, T. Robert; Willett, Lisa L.; Call, Stephanie; Halvorsen, Andrew J.; Chaudhry, Saima

doi:10.1097/acm.0000000000001419

Cited by 52 publications

(49 citation statements)

References 12 publications

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“…7 Prior survey data from both internal medicine programme directors and residents indicate that knowing when to seek assistance is one of the most important skills for new interns. 8,9 Our data demonstrate that interns with increased confidence in asking for help are more likely to do so appropriately. Hence, it may be worthwhile assessing incoming interns' self-perceptions of their ability in this task to identify those who may need additional intervention in this area.…”

Section: Discussionmentioning

confidence: 69%

“…Interns are often the frontline physicians; if they do not identify that a patient has an urgent problem, this may lead to adverse outcomes . Prior survey data from both internal medicine programme directors and residents indicate that knowing when to seek assistance is one of the most important skills for new interns . Our data demonstrate that interns with increased confidence in asking for help are more likely to do so appropriately.…”

Section: Discussionmentioning

confidence: 69%

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Are medical students trained in cross‐cover?

Heidemann

Fitzgerald

Hartley

2018

The Clinical Teacher

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The survey response rate was 69.8% (88 of 126), which included both partial and complete responses. Fifty-seven interns out of 85 (67.1%) had no formal training and 51 (60.0%) had no experience performing cross-cover. They reported feeling unprepared to provide cross-cover, with an average score of 1.8 on a 5-point Likert scale (1, not at all confident; 5, extremely confident). Interns had more confidence in performing cross-cover tasks if they had prior direct cross-cover experience (p = 0.001), and were the least confident in performing the initial evaluation and management of urgent issues (Likert score = 1.6). Scores on the sample case were correlated with the amount of prior experience with patients (p = 0.06). Only 77.7% of interns indicated that they would notify their senior resident in two urgent scenarios. Those who reported higher confidence in knowing when to ask for help were more likely to appropriately notify their senior colleague (p = 0.005). We identified gaps in cross-cover training and in the preparedness of incoming interns CONCLUSIONS: We identified gaps in cross-cover training and in the preparedness of incoming interns. This has important implications for the first day of residency, when interns are often asked to perform cross-coverage, yet feel unprepared to do so and express the greatest concern in urgent cross-cover scenarios. Addressing this curricular gap is crucial in assuring safe cross-cover care.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 69%

Are medical students trained in cross‐cover?

Heidemann

Fitzgerald

Hartley

2018

The Clinical Teacher

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“…4 In spite of these efforts to develop and use Entrustable Professional Activity (EPA)-based frameworks in undergraduate medical education, residency program directors (PDs) continue to express concerns about the preparedness of medical school graduates. 7,8 Studies have shown wide variability in PDs' confidence in interns' ability to perform CEPAERs. [7][8][9] There is a gap between PDs' perception of intern abilities and actual intern abilities.…”

Section: Introductionmentioning

confidence: 99%

Assessing Entrustable Professional Activities Using an Orientation OSCE: Identifying the Gaps

CarlLee

Rowat

Suneja

2019

Journal of Graduate Medical Education

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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-based objective structured clinical examination (OSCE) was implemented with the aims to (1) assess each intern's baseline clinical skills and provide formative feedback; (2) determine an intern's readiness for resident responsibilities; (3) inform individualized education plans; and (4) address identified gaps through curricular change.Methods During orientation, all 33 interns from internal medicine (categorical, preliminary, and medicine-psychiatry) participated in the OSCE. Six 20-minute stations evaluated 8 EPAs. Faculty completed a global assessment, and standardized patients completed a communications checklist and global assessment. All interns completed a self-assessment of baseline skills and a post-OSCE survey.Results Stations assessing handoffs, informed consent, and subjective, objective, assessment, and plan (SOAP) note were the lowest-performing stations. Interns performed lower in skills for which they did not report previous training. Formal instruction was incorporated into didactic sessions for the lowest-performing stations. The majority of interns indicated that the assessment was useful, and immediate feedback was beneficial.Conclusions This OSCE during orientation offers just-in-time baseline information regarding interns' critical skills and may lead to individualized feedback as well as continuous curricular improvement.

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“…Interns are expected to assume higher levels of responsibility and increased workloads in challenging clinical, social, and emotional contexts. Yet, gaps and variability in knowledge and skills among new interns have been identified by residency program directors [1][2][3] and empirical studies. [4][5][6][7] These gaps have prompted medical educators to focus on the fourth year of medical school as an opportunity to strengthen students' preparedness for internship.…”

Section: Introductionmentioning

confidence: 99%

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

Ferris

Sweet

et al. 2019

J GEN INTERN MED

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Internal Medicine Residency Program Directors’ Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum

Abstract: The gaps identified in Core EPA performance may help guide medical schools' curricular and assessment tool design. Sharing competency-based information at transitions along the medical education continuum could help ensure production of competent, practice-ready physicians.

Cited by 52 publications

References 12 publications

Are medical students trained in cross‐cover?

Are medical students trained in cross‐cover?

Assessing Entrustable Professional Activities Using an Orientation OSCE: Identifying the Gaps

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

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