Scientific Publications Database

Article Title: Creating Entrustable Professional Activities to Assess Internal Medicine Residents in Training A Mixed-Methods Approach
Authors: Taylor, David R.; Park, Yoon Soo; Smith, Christopher A.; Karpinski, Jolanta; Coke, William; Tekian, Ara
Journal: ANNALS OF INTERNAL MEDICINE Volume 168 Issue 10
Date of Publication:2018
Abstract:
Background: Competency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work.Objective: To develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, Admit and manage a medical inpatient with a new acute problem).Design: A modified Delphi process involving clinical experts followed by a conference of educational experts.Setting: The Royal College of Physicians and Surgeons of Canada.Participants: In phase 1 of the project, members of the Specialty Committee for Internal Medicine participated in a modified Delphi process to identify activities in internal medicine that represent the scope of the specialty. In phase 2 of the project, 5 experts who were scholars and leaders in competency-based medical education reviewed the results.Measurements: Phase 1 identified important activities, revised descriptions to improve accuracy and avoid overlap, and as-signed activities to stages of training. Phase 2 compared proposed activity descriptions with published guidelines for their development and application in medical education.Results: The project identified 29 activities that qualify as entrustable professional activities. The project also produced a detailed description of each activity and guidelines for using them to assess residents.Limitation: These activities reflect the practice patterns of the developers and may not fully represent internal medicine practice in Canada.Conclusion: Identification of these activities is expected to facilitate modification of training and assessment programs for medical residents so that programs focus less on isolated skills and more on integrated tasks.