Abstract
This article was migrated. The article was marked as recommended. In medical education, there have been three important reforms: science-based curriculum, problem-based learning, and competency-based education. Currently, the concept of Entrustable Professional Activities (EPA) goes a step beyond competencies. The aim of this paper is twofold: first, to present a proposal for an EPA-based curriculum for undergraduate medical education, and second, to describe its curricular framework, educational model and organization. This curricular proposal integrates EPA-based education with the foundations of the interpretive epistemology, the constructivist paradigm and the health care transformations. Using Actividades Profesionales Confiables (APROC) as a curricular guideline helps the educators define knowledge, skills, and attitudes; teachers can plan activities that link theory to practice; evaluators can assess the student's performance and provide him with feedback, and Faculty leaders and collaborators can implement projects to improve educational quality. The curriculum proposal includes a flexible modular system, the integration of biomedical, socio-medical and clinical sciences, and a close link between theory and practice. This curriculum puts medical education at the forefront, it favors the comprehensive education of future physicians, and it constitutes a true educational revolution.
Highlights
In medical education, there have been three important reforms
To proceed into the transformation of medical education, the curricular proposal integrates Entrustable Professional Activities (EPA)-based education and the foundations of (Hamui-Sutton et al, 2018): the interpretative epistemology that supports the idea that theory is interpreted in the light of experience in concrete contexts, with the organizational, social and personal elements in which practice and reflection take place. the constructivist paradigm which considers that reality is socially constituted and is based on experience
Afterwards, it is important for a clinical teacher, other physicians, and residents to assess the students, as they, as clinical experts, can provide feedback about how to improve and what to correct. The curriculum applies these medical principles: "Treat the patient, not just the disease!", "To be a great physician, you must understand the whole story", "Sometimes to cure, often to relieve and always to comfort" and "Each patient is a unique human being, not a disease or a group of symptoms". These aphorisms demand acting on medical education, emphasizing the integration and balance between three principles: science, humanism, and society, because a general physician must be reliable in any task where he/she provides care
Summary
At the beginning of the 20th century, with science-based curriculum-guided teaching, the curriculums were divided into subjects and there was a clear limit between "basic" and "clinical" sciences. Mid-20th century, some schools implemented the problem-based learning (PBL) approach. Late in the 20th century, medical schools adopted the flexible curricular models of competency-. The concept of entrustable professional activities (EPA) is a proposal that helps to make a competency-based curriculum operational (ten Cate, 2005). The aim of this paper is twofold: first, to present a proposal for an EPA-based curriculum for undergraduate medical education (UME), and second, to describe its curricular framework, educational model and organization
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