Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

Abstract

Background Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. Methods We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. Results We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. Conclusions There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.

Medical Student Portfolios: A Systematic Scoping Review

“…We believe that it is possible to harness these overlapping aspects to make MSPs more widely applicable. Here, we build upon the notion that micro-credentialling that incorporates “circumscribed assessments” of a specific EPA, such as “interpreting and communicating results of common diagnostic and screening tests”, may be extrapolated to other EPAs such as “[communicating] in difficult situations” in a different practice setting 97 .…”

Development and evaluation of an interprofessional student-led influenza vaccination clinic for medical, nursing and pharmacy students

“…Entrustable Professional Activities (EPAs) have been designed to integrate academic learning with activities required for practice. 26 The EPA model is increasingly being used in the entry level degrees of many health professions to prepare students for practice, [27][28][29] ensuring that they have the required combination of knowledge, skills, and attitudes to be effective practitioners. EPAs are assessed on a five-point scale of observable behaviours: 30 1.…”

Consideraciones sobre la formación basada en competencias y el enfoque Una Salud

“…Cuando se discuten los modelos de diseños curriculares más adecuados para la formación profesional, se recurre al análisis de los niveles de integración curricular en medicina humana basado en la escalera de Harden (Escanero Marcén, 2007) y, más recientemente, en el Modelo Educativo para Desarrollar Actividades Profesionales Confiables (MEDAPROC) (Hamui-Sutton et al, 2018y 2019Francischetti et al, 2020;Pinilla et al, 2021). A medida que se asume un diseño curricular más integrado, con una visión profesionalizante no tradicional, centrado en los estudiantes, la concepción del enfoque por competencias va modificándose.…”