Entrustable professional activities (EPAs) for undergraduate medical education – development and exploration of social validity

BMC Medical Education - Tập 23 Số 1
Christina Gummesson1, Stina Alm2, Anna Cederborg3, Mattias Ekstedt4, Jarl Hellman5, Hans Hjelmqvist6, Magnus Hultin7, Katarina Jood8, Charlotte Leanderson9, Bertil Lindahl5, Riitta Möller10, Björn Rosengren11, Anders Själander12, Peter Svensson13, Stefan Särnblad14, Alexander Tejera15
1Faculty of Medicine, Faculty of Odontology, Lund University, Malmö University, Malmö, Sweden
2Department of Clinical Sciences, Futurum - the Academy for Health and Care, Region Jönköping County, Umeå University, Paediatrics, Umeå, Sweden
3Institute of Medicine, Sahlgrenska Academy, Department of Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
4Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
5Department of Medical Sciences, Uppsala University, Uppsala, Sweden
6Department of Anesthesiology and Intensive Care, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
7Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden
8Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Department of Neurology, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
9Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
10Department of Clinical Science, Intervention and Technology, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Karolinska Institutet, Stockholm, Sweden
11Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skåne University Hospital Malmö, Lund University, Malmö, Sweden
12Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
13Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
14Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
15Division of Translational Cancer Research, Department of Laboratory Medicine, Skåne University Hospital, Lund University, Lund University, Lund, Sweden

Tóm tắt

Abstract Background The development of entrustable professional activities (EPAs) as a framework for work-based training and assessment in undergraduate medical education has become popular. EPAs are defined as units of a professional activity requiring adequate knowledge, skills, and attitudes, with a recognized output of professional labor, independently executable within a time frame, observable and measurable in its process and outcome, and reflecting one or more competencies. Before a new framework is implemented in a specific context, it is valuable to explore social validity, that is, the acceptability by relevant stakeholders. Aim The aim of our work was to define Core EPAs for undergraduate medical education and further explore the social validity of the constructs. Method and material In a nationwide collaboration, EPAs were developed using a modified Delphi procedure and validated according to EQual by a group consisting of teachers nominated from each of the seven Swedish medical schools, two student representatives, and an educational developer (n = 16). In the next step, social validity was explored in a nationwide survey. The survey introduced the suggested EPAs. For each EPA, the importance of the EPA was rated, as was the rater’s perception of the present graduates’ required level of supervision when performing the activity. Free-text comments were also included and analyzed. Results Ten Core EPAs were defined and validated. The validation scores for EQual ranged from 4.1 to 4.9. The nationwide survey had 473 responders. All activities were rated as “important” by most responders, ranging from 54 to 96%. When asked how independent current graduates were in performing the ten activities, 6 to 35% reported “independent”. The three themes of the free text comments were: ‘relevant target areas and content’; ‘definition of the activities’; and ‘clinical practice and learning’. Conclusion Ten Core EPAs were defined and assessed as relevant for Swedish undergraduate medical education. There was a consistent gap between the perceived importance and the certainty that the students could perform these professional activities independently at the time of graduation. These results indicate that the ten EPAs may have a role in undergraduate education by creating clarity for all stakeholders.

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Tập 23 Số 1

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