Abstract
BackgroundEntrustable professional activities (EPAs) are those activities that a health professional can perform without direct supervision in a defined environment. Bridging the gap between competencies and learning objectives, EPAs have made assessing the performances of health professional more realistic. The main objective of the present study was developing and customizing EPAs for Iranian Internal Medicine Residency Programs.ResultsAfter reviewing the publications, residency curricula and logbooks, and collecting experts’ ideas, the initial list of EPAs was developed. Then, in a focus group, the list was refined, the entrustability level of each residency year was determined, and finally, the EPA-competency cross-tab was established, and in the next step, through a one- round Delphi, the results were validated. Twenty-eight EPAs were developed. Some of them were definitely suitable for the higher levels of residency, such that they had to be accomplished under direct supervision until the end of the program. On the other hand, some of EPAs were those that residents, even from the first year, are expected to perform independently or under indirect supervision. Most of the EPAs cover a wide range of competencies.ConclusionDetermining the entrustability level of each residency year in each EPA as well as the competency- EPA matrix has crucial effect on the quality of the graduates. It seems that our findings are applicable in developing countries like Iran.
Highlights
Transition to the paradigm of competency-based education, from process- based or time-based one, requires attainment of a shared language and transforming the competencies to such constructs that are not too much subjective [1,2,3]
We extend them to six steps as follows: 1) Determining the characteristics of Entrustable professional activities (EPAs): These features were used as the main criteria for defining, processing and validating the EPAs in the following steps
2) Reviewing the literature and publications through a scoping review: This step was accomplished for fining the update EPAs developed for internal medicine
Summary
Transition to the paradigm of competency-based education, from process- based or time-based one, requires attainment of a shared language and transforming the competencies to such constructs that are not too much subjective [1,2,3] It has been unclear what is expected from the learner to perform in the practical context [4]. It is essential to apply instruments capable to measure and evaluate the subjective and complicated constructs of competencies, along with helping medical schools become more socially accountable [14]. Such examinations must be as much authenticate as possible [15].
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