The effect of entrustable professional activities on pathology resident confidence in blood banking/transfusion medicine

Abstract

BACKGROUND The Accreditation Council for Graduate Medical Education requires milestone reporting of the Six General Core Competencies. Additionally, Graduate Medical Education (GME) is transitioning to adopt competency‐based education methodologies including entrustable professional activities (EPAs) for objective, observable, and measurable milestone progression. The College of American Pathologists published 19 EPAs, including one for transfusion‐related adverse events. This survey study includes developing EPAs for transfusion reaction evaluation and assessing residents before and after implementing these EPAs. STUDY DESIGN AND METHODS Three transfusion reaction EPAs were developed and implemented in July 2018 for the Postgraduate Year (PGY) 2 pathology residents. An online, anonymous survey was sent to all 21 pathology trainees before and one year after EPA implementation. In July 2018 and August 2019, each survey included the same six multiple‐choice, single‐response, confidence questions, with a rating scale of extremely, very, slightly, or not at all confident. This study was approved by the hospitalʼs Institutional Review Board for Health Sciences Research and GME Committee. RESULTS Analysis was performed on PGY2‐4 residents. In 2018, 13 of 20 participants were analyzed. In 2019, 15 of 19 participants were analyzed. Number and percentage of responses were reported. The results showed an increase in trainee confidence, with the greatest improvement among the first class to use the EPAs. CONCLUSION EPAs provide an effective framework for objective and measurable progression of trainees. One year after the implementation of transfusion reaction EPAs at our site, the trainees showed enhanced confidence levels in handling Blood Bank and Transfusion Medicine Services coverage.

Entrustable professional activities for apheresis medicine education

“…The Pathology Milestones Supplemental Guide provides examples for each milestone primarily relevant to anatomic pathology, with few examples specific to blood banking, transfusion medicine, and apheresis. 16 An EPA is a standardized method for evaluating learner competency through documented activities, experiences, and/or instruction. 4,[16][17][18] Each EPA is observable and measureable and can be designed to align with a subcompetency milestone to document the traineeʼs progression.…”

“…16 An EPA is a standardized method for evaluating learner competency through documented activities, experiences, and/or instruction. 4,[16][17][18] Each EPA is observable and measureable and can be designed to align with a subcompetency milestone to document the traineeʼs progression. The College of American Pathologists Graduate Medical Education Committee developed 19 EPAs (7 anatomic pathology, 4 clinical pathology, 8 both) for pathology graduate medical education in anatomic and clinical pathology residency training.…”

“…2 EPAs have been developed for transfusion reaction evaluation and reporting but none specific for apheresis education is currently available in the literature. 16 The AM EPAs outlined by the GME subcommittee of the ASFA Physicians Committee provides detailed tasks and descriptions mapped to Milestone competencies and suggested assessment methods that can be used in the training program for apheresis practitioners. The core competencies outlined by the Pathology Milestones refer to observable skills or abilities of an individual, while EPAs refer to a professional task that often requires skills from across a range of competencies.…”

“…The Pathology Milestones present activities but do not provide a specific method for performance or for evaluation. The Pathology Milestones Supplemental Guide provides examples for each milestone primarily relevant to anatomic pathology, with few examples specific to blood banking, transfusion medicine, and apheresis 16 …”

“…An EPA is a standardized method for evaluating learner competency through documented activities, experiences, and/or instruction 4,16–18 . Each EPA is observable and measureable and can be designed to align with a subcompetency milestone to document the traineeʼs progression.…”