Entrustment Decision Making in EPA-Based Curricula
Times are Changing: Evolution and Revolution in Medical Education – Strategies for Assessment of Skills, Attitudes, and Behaviors across the Health Sciences
Contemporary health science curricula have increasingly expanded beyond teaching knowledge and skills to fostering attitudes, behaviors and elements of professionalism.
The fall IAMSE seminar series addresses approaches by which these qualities and activities can be assessed in learners when they are not easily quantified by standard methods. The presentations will address contemporary approaches to assessing entrustable professional activities, clinical skills, and non-cognitive components critical to careers in health professions such as life-long learning and professional behaviors.
Sessions will focus on using simulation to teach and assess basic science knowledge and skills, assessment of “self-directed, life-long learning”, utilization of standardized patient educators in clinical skills assessment, and effective strategies for assessing professionalism. In addition, there will be a session on “defining competency, milestones and EPAs”, further developing their relationship, and addressing the challenge associated with their assessment. Throughout the series the audience will be invited to contribute to the discussion by sharing their experiences via telephone or our newly implemented backchannel communication leading to a stimulating and thought provoking experience that will inform current thinking on the issues.
Assessment of clinical competence is an ongoing topic of debate among medical educators. Competency-based medical education intends to train and assess residents and students who meet predefined standards. The quest for psychometrically valid assessments, i.e. sound measurement of trainee competencies, to provide sufficient certainty to the public that all those who complete undergraduate medical education are ready for residency, and all those who complete graduate medical education are ready for unsupervised practice, has not yet yielded a gold standard for evaluation. A new concept in workplace training and assessment is Entrustable Professional Activities (EPAs), units of professional practice that learners may execute without supervision once they have satisfactorily demonstrated to possess the relevant competence in postgraduate specialty training, or indirect supervision in undergraduate medical education. EPA-based curricula with entrustment decisions provide a conceptual change in perspective on both the standards for competence and their evaluation among trainees. This presentation will focus on entrustable professional activities for curriculum development and assessment, the concept of entrustment as part of assessment and entrustability scales that use levels of supervision as anchor points. The connection with milestones will be highlighted. While EPA-based assessment is new and there is yet limited experience with EPA-based curricula, there are a number of arguments to guide a development in that direction.
Olle ten Cate, PhD
University Medical Center Utrecht
Olle ten Cate attended medical school at the University of Amsterdam, the Netherlands and has spent his professional life from 1980 serving medical education. In 1986 he completed a PhD dissertation on peer teaching in medical education. Until 1999 he was closely involved with all of the University of Amsterdam’s major preclinical and clinical curriculum reforms, education research, program evaluation and educational development. In 1999 he was appointed full professor of Medical Education at Utrecht University, the Netherlands, and program director of undergraduate medical education at University Medical Center Utrecht. Since 2005 he leads the Center for Research and Development of Education at UMCU. His research interests include curriculum development, peer teaching, competency-based medical education, and many other topics. From 2006 until 2012 he served as president of the Netherlands Association for Medical Education. In 2012 was appointed adjunct professor of medicine at the University of California, San Francisco, next to his work in Utrecht. He has published extensively in the medical education literature (250+) and supervised and supervises many doctoral students (25+) in medical education research.
- 1.00 CE Contact Hours