Assessment of final-year medical students' entrustable professional activities after education on an interprofessional training ward: A case-control study.
Entrustable professional activities
Interpersonal skills
Interprofessional training ward
Undergraduate medical education
Journal
Perspectives on medical education
ISSN: 2212-277X
Titre abrégé: Perspect Med Educ
Pays: Netherlands
ID NLM: 101590643
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
01
02
2022
accepted:
27
06
2022
revised:
12
06
2022
pubmed:
22
7
2022
medline:
22
10
2022
entrez:
21
7
2022
Statut:
ppublish
Résumé
Interprofessional training wards (ITWs) are implemented to provide medical students with a holistic and authentic health care experience to improve their clinical competencies. Controlled outcome studies assessing students' competencies after ITW-training are uncommon. In this case-control study, we assessed final-year medical students who received ITW-training regarding entrustable professional activities (EPAs) and communicative as well as social competencies. In March 2021, 32 final-year students, 16 with (ITW group) and 16 without (control group) a previous four-week placement on an ITW participated in a training simulating the first day of residency. The simulated patients assessed students' communication and interpersonal skills for history taking with the ComCare index after every consultation. Twelve prospective EPAs were assessed by three senior physicians after watching videos of the students' case presentations. While baseline characteristics and ComCare index ratings were not significantly different between the two groups, the overall mean entrustment level for the 12 EPAs was significantly higher (p < 0.001) in the ITW group compared to the control group (median = 3.15 versus 2.22). The interrater reliability for all EPAs was high and entrustment in students from the ITW group was significantly higher in 10 out of 12 EPAs. ITW training seems to prepare medical students well to practice competencies which are relevant for prospective entrustment decisions and can be deduced by senior physicians from case presentations. Further studies with larger student cohorts are needed to corroborate this finding and observable EPAs could also be defined to assess students' competencies after ITW training.
Identifiants
pubmed: 35864296
doi: 10.1007/s40037-022-00720-0
pii: 10.1007/s40037-022-00720-0
pmc: PMC9302559
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
266-272Informations de copyright
© 2022. The Author(s).
Références
Suter E, Arndt J, Arthur N, Parboosingh J, Taylor E, Deutschlander S. Role understanding and effective communication as core competencies for collaborative practice. J Interprof Care. 2009;23:41–51.
doi: 10.1080/13561820802338579
Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376:1923–58.
doi: 10.1016/S0140-6736(10)61854-5
Fischer MR, Bauer D, Mohn K. NKLM-Projektgruppe. Finally finished! National competence based catalogues of learning objectives for undergraduate medical education (NKLM) and dental education (NKLZ) ready for trial. GMS Z Med Ausbild. 2015;32:Doc35.
Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 physician competency framework. Ottawa: Ottawa Royal College of Physicians and Surgeons of Canada; 2015.
Reeves S, Fletch S, Barr H, et al. A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Med Teach. 2016;38:656–68.
doi: 10.3109/0142159X.2016.1173663
Reeves S, Freeth D. The London training ward: An innovative interprofessional learning initiative. J Interprof Care. 2002;16:41–52.
doi: 10.1080/13561820220104159
Meek R, Morphet J, Hood K, Leech M, Sandry K. Effect of interprofessional student-led beds on emergency department performance indicators. Emerg Med Australas. 2013;25:427–34.
doi: 10.1111/1742-6723.12118
Morphet J, Hood K, Cant R, Baulch J, Gilbee A, Sandry K. Teaching teamwork: An evaluation of an interprofessional training ward placement for health care students. Adv Med Educ Pract. 2014;41:197–204.
Oosterom N, Floren LC, Ten Cate O, Westerveld HE. A review of interprofessional training wards: Enhancing student learning and patient outcomes. Med Teach. 2018;41:547–54.
doi: 10.1080/0142159X.2018.1503410
Hallin K, Henriksson P, Dalén N, et al. Effects of interprofessional education on patient perceived quality of care. Med Teach. 2011;33:e22–6.
doi: 10.3109/0142159X.2011.530314
Hallin K, Gordon M, Sköldenberg O, et al. Readmission and mortality in patients treated by interprofessional student teams at a training ward compared with patients receiving usual care: A retrospective cohort study. BMJ Open. 2018;8:e22251.
doi: 10.1136/bmjopen-2018-022251
Wijnen-Meijer M, van der Schaaf M, Nillesen K, Harendza S, ten Cate O. Essential facets of competence that enable trust in medical gradates: A ranking study among physician educators in two countries. Perspect Med Educ. 2013;2:290–7.
doi: 10.1007/s40037-013-0090-z
Fürstenberg S, Schick K, Deppermann J, et al. Competencies for first year residents—Physicians’ views from medical schools with different undergraduate curricula. BMC Med Educ. 2017;17:154.
doi: 10.1186/s12909-017-0998-9
Wijnen-Meijer M, Van der Schaaf M, Booij E, et al. An argument-based approach to the validation of UHTRUST: Can we measure how recent graduates can be trusted with unfamiliar tasks? Adv Health Sci Educ Theory Pract. 2013;18:1009–27.
doi: 10.1007/s10459-013-9444-x
Fincke F, Prediger S, Schick K, et al. Entrustable professional activities and facets of competence in a simulated workplace-based assessment for advanced medical students. Med Teach. 2020;42:1019–26.
doi: 10.1080/0142159X.2020.1779204
Ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39:1176–7.
doi: 10.1111/j.1365-2929.2005.02341.x
Ten Cate O, Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140. Med Teach. 2021;43:1106–14.
doi: 10.1080/0142159X.2020.1838465
Hauer KE, Boscarcin C, Fulton TB, Lucey C, Oza S, Teherani A. Using a curricular vision to define entrustable professional activities for medical student assessment. J Gen Intern Med. 2015;30:1344–8.
doi: 10.1007/s11606-015-3264-z
Taylor D, Park YS, Smith C, ten Cate O, Tekian A. Constructing approaches to entrustable professional activity development that deliver valid descriptions of professional practice. Teach Learn Med. 2021;33:89–97.
doi: 10.1080/10401334.2020.1784740
Ten Cate O, Carraccio C, Damodaran A, et al. Entrustment decision making: Extending Miller’s pyramid. Acad Med. 2021;96:199–204.
doi: 10.1097/ACM.0000000000003800
Persky AM, Fuller KA, ten Cate O. True entrustment decisions regarding entrustable professional activities happen in the workplace, not in the classroom setting. Am J Pharm Educ. 2021;85:8536.
doi: 10.5688/ajpe8536
Pandya A, Patocka C, Huffman J. Simulation for assessment of entrustable professional activities in an emergency residency program. CJEM. 2022;24:84–7.
doi: 10.1007/s43678-021-00209-5
Peng CR, Schertzer KA, Caretta-Weyer HA, et al. Assessment of entrustable professional activities using a web-based simulation platform during transition to emergency medicine residency: Mixed methods pilot study. JMIR Med Educ. 2021;7:e32356.
doi: 10.2196/32356
Duggan N, Curran VR, Fairbridge NA, et al. Using mobile technology in assessment of entrustable professional activities in undergraduate medical education. Perspect Med Educ. 2021;10:373–7.
doi: 10.1007/s40037-020-00618-9
Prediger S, Schick K, Fincke F, et al. Validation of a competence-based assessment of medical students’ performance in the physician’s role. BMC Med Educ. 2020;20:6.
doi: 10.1186/s12909-019-1919-x
Wijnen-Meijer M, ten Cate O, van der Schaaf M, Burgers C, Borleffs J, Harendza S. Vertically integrated medical education and the readiness for practice of graduates. BMC Med Educ. 2015;15:229.
doi: 10.1186/s12909-015-0514-z
Zimmerhackl M, Schick K, Kadmon M, Harendza S, Gartmeier M, Berberat PO. Bedeutung des ersten Eindruckes im Anvertrauen von professionellen ärztlichen Tätigkeiten. In: Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA). Zürich, Switzerland, 16–17 September 2021. Düsseldorf: German Medical Sciences GMS Publishing House; 2021. https://doi.org/10.3205/21gma093 . DocV24–04.
doi: 10.3205/21gma093
Harendza S, Gärtner J, Zelesniack E, Prediger S. Evaluation of a telemedicine-based training for final-year medical students including simulated patient consultations, documentation, and case presentation. GMS J Med Educ. 2020;37:Doc94.
Nikendei C, Krautter M, Celebi N, Obertacke U, Jünger J. Final year medical education in Germany. Z Evid Fortbild Qual Gesundhwes. 2012;106:75–84.
doi: 10.1016/j.zefq.2012.01.002
Schick K, Eissner A, Wijnen-Meijer M, et al. Implementing a logbook on entrustable professional activities in the final year of undergraduate medical education in Germany—A multicentric pilot study. GMS J Med Educ. 2019;36:Doc69.
Gärtner J, Bußenius L, Schick K, et al. Validation of the ComCare index for rater-based assessment of medical communication and interpersonal skills. Patient Educ Couns. 2022;105:1004–8.
doi: 10.1016/j.pec.2021.07.051
Mulder H, ten Cate O, Daalder R, Berkvens J. Building a competency-based workplace curriculum around entrustable professional activities: the case of physician assistant training. Med Teach. 2020;32:e453–9.
doi: 10.3109/0142159X.2010.513719
Bußenius L, Harendza S, van den Bussche H, Selch S. Final-year medical students’ self-assessment of facets of competence for beginning residents. BMC Med Educ. 2022;22:82.
doi: 10.1186/s12909-021-03039-2
Ten Cate O, Chen HC. The ingredients of a rich entrustment decision. Med Teach. 2020;42:1413–20.
doi: 10.1080/0142159X.2020.1817348
Fürstenberg S, Harendza S. Differences between medical student and faculty perceptions of the competencies needed for the first year of residency. BMC Med Educ. 2017;17:198.
doi: 10.1186/s12909-017-1036-7
Peters H, Holzhausen Y, Boscardin C, Ten Cate O, Chen HC. Twelve tips for the implementation of EPAs for assessment and entrustment decisions. Med Teach. 2017;39:802–7.
doi: 10.1080/0142159X.2017.1331031
Rheingans A, Soulos A, Mohr S, Meyer J, Guse AH. The Hamburg integrated medical degree program iMED. GMS J Med Educ. 2019;36:Doc52.
Bachmann C, Pettit J, Rosenbaum M. Developing communication curricula in healthcare education: an evidence-based guide. Patient Educ Couns. 2021;105(7):2320–7.
doi: 10.1016/j.pec.2021.11.016
Postmes L, Tammer F, Posthumus I, Wijnen-Meijer M, van der Schaaf M, ten Cate O. EPA-based assessment: Clinical teachers’ challenges when transitioning to a prospective entrustment-supervision scale. Med Teach. 2021;43(4):404–10.
doi: 10.1080/0142159X.2020.1853688
Van Enk A, ten Cate O. “Languaging” tacit judgment in formal postgraduate assessment: The documentation of ad hoc and summative entrustment decisions. Perspect Med Educ. 2020;9:373–8.
doi: 10.1007/s40037-020-00616-x
Brewer ML, Stewart-Wynne EG. An Australian hospital-based student training ward delivering safe, client-centred care while developing students’ interprofessional practice capabilities. J Interprof Care. 2013;27:482–8.
doi: 10.3109/13561820.2013.811639
McGettigan P, McKendree J. Interprofessional training for final year healthcare students: A mixed methods evaluation of the impact on ward staff and students of a two-week placement and of factors affecting sustainability curriculum development. BMC Med Educ. 2015;15:185.
doi: 10.1186/s12909-015-0436-9
Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. J Interprof Care. 2012;26:319–25.
doi: 10.3109/13561820.2012.676109
Mette M, Baur C, Hinrichs J, Narciß E. Gaining interprofessional knowledge and interprofessional competence on a training ward. Med Teach. 2021;43:583–9.
doi: 10.1080/0142159X.2021.1885638
Mink J, Mitzkat A, Krug K, et al. Impact of an interprofessional training ward on interprofessional competencies—A quantitative longitudinal study. J Interprof Care. 2021;35:751–9.
doi: 10.1080/13561820.2020.1802240