How an EPA-based curriculum supports professional identity formation

Anne E Bremer,Roland F J M Laan,Marjolein H J Van De Pol,Cornelia R M G Fluit

doi:10.1186/s12909-022-03116-0

Abstract

BackgroundEntrustable professional activities (EPAs) are widely used in medical education, and they might be an important incentive to stimulate professional identity formation (PIF) of medical students, by actively encouraging participation in the workplace. The goal of this study was to explore the effects of an EPA-based curriculum on the PIF of medical students in undergraduate curricula.MethodsIn this study at the Radboud University Medical Center in Nijmegen, the Netherlands, the authors interviewed twenty-one medical students in three focus group interviews (November 2019), and conducted a thematic analysis based on both the synthesizing concepts PIF, communities of practice and EPAs, and newly defined themes.ResultsFour central themes proved crucial for understanding the influence of EPAs on PIF: creating learning opportunities, managing feedback, dealing with supervision in context and developing confidence. EPAs helped students to create learning opportunities and to choose activities purposefully, and the use of EPAs stimulated their feedback-seeking behavior. The context and way of supervision had a great impact on their development, where some contexts offer better learning opportunities than others. EPAs helped them develop trust and self-confidence, but trust from supervisors hardly appears to result from using EPAs.ConclusionsAn EPA-based curriculum does stimulate PIF in the complex context of working and learning by supporting participation in the workplace and by encouraging feedback-seeking behavior. Striking the right balance between participation, feedback-seeking behavior and choosing learning activities is essential.Trial registrationThis study was approved by the ethics committee of the Netherlands Association of Medical Education (NVMO, case number 2019.5.12).

Highlights

Entrustable professional activities (EPAs) are widely used in medical education, and they might be an important incentive to stimulate professional identity formation (PIF) of medical students, by actively encouraging participation in the workplace
In this study we focus on EPAs instead of competencies, as EPAs describe tasks to be performed in the workplace
The lead author (AB) is an educationalist, Cornelia Fluit (CF) is a professor in workplace learning with a medical and educationalist background, Marjolein van de Pol (MP) is an associate professor on wellbeing, a general practitioner and educational researcher and Roland Laan (RL) is a director of an educational institute, a professor in medical education and MD

Summary

Introduction

Entrustable professional activities (EPAs) are widely used in medical education, and they might be an important incentive to stimulate professional identity formation (PIF) of medical students, by actively encouraging participation in the workplace. Students have already formed part of their personal identity shaping their personalities through life experiences [5]. To their personal identity, students develop a professional identity, as shown by Cruess and colleagues [5]. Participation in the clinical workplace can help students to take responsibility for their own role [6] and to develop a professional identity [7] and, in addition, it encourages them to become more sensitive towards patients, which improves healthcare [8]. PIF aims to ensure that learners understand and internalize the professional morals and ethics of their profession [10–12]

Objectives

Methods

Results

Discussion

Conclusion