Using a Curricular Vision to Define Entrustable Professional Activities for Medical Student Assessment

Hauer, Karen E.; Boscardin, Christy; Fulton, Tracy B.; Lucey, Catherine R.; Oza, Sandra K.; Teherani, Arianne

doi:10.1007/s11606-015-3264-z

Cited by 37 publications

(20 citation statements)

References 22 publications

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“…Despite ongoing efforts to enhance professionalism and humanistic approaches among medical students, [53][54][55] less attention has been paid to the intrinsic motivators that sustain practicing physicians. 24,25 Perhaps few medical practitioners or policymakers recognize the significant existing relationship between intrinsic factors and career outcomes.…”

Section: Discussionmentioning

confidence: 99%

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

2017

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BACKGROUND: Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE: To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfaction, and clinical commitment, while accounting for established extrinsic motivators as well. DESIGN AND PARTICIPANTS: A nationally representative survey of 2000 US physicians, fielded October to December 2011. MAIN MEASURES: Outcome variables were five measures of physician well-being: career satisfaction, life satisfaction, high life meaning, commitment to direct patient care, and commitment to clinical practice. Primary explanatory variables were sense of calling, personally rewarding hours per day, meaningful, long-term relationships with patients, and burnout. Multivariate logit models with survey design provided nationally representative individual-level estimates. KEY RESULTS: Among 1289 respondents, 85.8% and 86.5% were satisfied with their career and life, respectively; 88.6% had high life meaning; 54.5% and 79.5% intended to retain time in direct patient care and continue clinical practice, respectively. Sense of calling was strongly positively associated with high life meaning (odds ratio [OR] 5.14, 95% confidence interval [95% CI] 2.87-9.19) and commitment to direct patient care (OR 2.50, 95% CI 1.53-4.07). Personally rewarding hours per day were most strongly associated with career satisfaction (OR 5.28, 95% CI 2.72-10.2), life satisfaction (OR 4.46, 95% CI 2.34-8.48), and commitment to clinical practice (OR 3.46, 95% CI 1.87-6.39). Long-term relationships with patients were positively associated with career and life satisfaction and high life meaning. Burnout was strongly negatively associated with all measures of physician wellbeing. CONCLUSIONS: Intrinsic motivators (e.g., calling) were associated with each measure of physician well-being (satisfaction, meaning, and commitment), but extrinsic motivators (e.g., annual income) were not associated with meaning or commitment. Understanding the effects of intrinsic motivators may help inform efforts to support physician well-being.

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Section: Discussionmentioning

confidence: 99%

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

2017

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“…EPAs can be disaggregated into a list of essential skills that can be mapped to competencies. 24,29 However, as EPAs are deconstructed, the risk is that they may become too checklistdriven. In this study, the risk was mitigated by grouping the EPA components into categories so that the number of items in each final EPA rubric was kept to a manageable number.…”

Section: Discussionmentioning

confidence: 99%

“…Instead, the supervisor makes an overall judgment about a trainee's ability based on a number of sources of information related to the essential skills required to successfully complete the procedure. 29 For EPAs to be used in a program of assessment, the essential skills necessary for entrustment to occur must first be identified. In this study, we aimed to (1) define the essential skills required for entrustment to occur for 7 bedside procedures, and (2) develop an EPA-based assessment tool for procedural skills.…”

Section: Introductionmentioning

confidence: 99%

Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

Pugh

Cavalcanti

Halman

et al. 2017

Journal of Graduate Medical Education

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“…Establishment of competency goals for medical students in the workplace will help to ensure that every graduate is prepared for practice. Recording of medical students' observable abilities, such as the demonstration of entrustable professional activities [4], may allow a transparent means to monitor their development as physician learners.…”

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confidence: 99%

Medical Student Contributions In The Workplace: Can We Put a Value on Priceless?

2016

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As healthcare reform evolves, economic pressure intensifies, and education budgets come under increased scrutiny, there is growing interest in understanding the specific contributions of medical students to patient care and the healthcare settings in which they train and participate. Contributions may include patient-centered (i.e. health coaching) [1] and team-centered assistance (i.e. prevention of errors) [2]. However, there are many challenges to measuring this value [3].The first challenge is we have little shared understanding of how we define either value or contributions. For example, many medical school faculty can point to specific instances in which their student contributions have been invaluable, but very few have an overarching framework for identifying overall value. Second, in a complex team setting, understanding the unique contributions of a single team member is difficult and in some cases impossible. As healthcare teams increasingly rely on a multitude of interprofessional team members (i.e. nursing, social work, pharmacy, physical therapy, etc.) individual roles and contributions become further blended. Finally, as many more medical schools are blurring the lines between the traditional Flexnerian 2 + 2 year model (i.e. 2 years of basic science followed by 2 years of clinical rotations) and incorporate earlier clinical rotations (i.e. after 1 year rather than 2) faculty struggle to understand the developmental trajectory and therefore roles and contributions of medical students in the workplace.In order to move our collective understanding of this problem forward, we propose that a series of research projects be undertaken. It would be very helpful to define nomenclature around medical student contributions. This would then enable stakeholders to quantify contributions across settings and stu-

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Using a Curricular Vision to Define Entrustable Professional Activities for Medical Student Assessment

Cited by 37 publications

References 22 publications

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

Medical Student Contributions In The Workplace: Can We Put a Value on Priceless?

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