Collins Eric, Stahl Christopher, Schnapp Benjamin, Westergaard Mary, Greenberg Jacob, Jung Sarah, Rosser Alexandra, Minter Rebecca, Hamedani Azita, Kraut Aaron
Department of Emergency Medicine University of Wisconsin Hospitals and Clinics Madison WI USA.
and the Mayo Clinic Health System Eau Claire WI USA.
AEM Educ Train. 2020 Dec 16;5(3):e10561. doi: 10.1002/aet2.10561. eCollection 2021 Jul.
Entrustable professional activities (EPAs) are a new tool for assessing learners that represents a significant movement in graduate medical education (GME) toward competency-based assessment and serves as a bridge between milestones and clinical practice. Whenever a major change is implemented to any system, resistance to change is expected. Many change management models have been proposed to overcome this resistance; a newer model is outlined in the book . The objective was to describe the change management principles used to institute an EPA.
The model introduced in was used as a framework for implementing a trauma resuscitation EPA in a joint effort between the departments of surgery and emergency medicine (EM) at the University of Wisconsin Hospitals and Clinics. The Department of Emergency Medicine used the principles of change management, completing 295 faculty evaluations of trauma resuscitations compared to the Department of Surgery, whose faculty completed 50 evaluations between the study period of July 2018 through October 2019. A survey completed winter 2019 of EM faculty was used to determine the most important principles toward successful implementation.
Twenty-seven of 35 (78% response rate) of EM faculty identified key concepts from as being instrumental in the successful implementation. Internal discussion of the implementation approach used by the Department of Surgery identified several limitations that would have been overcome by using these same change management principles.
We conclude that the principles of change management provide a useful framework for successfully implementing EPAs into GME.
可托付专业活动（EPA）是一种评估学习者的新工具，代表了毕业后医学教育（GME）向基于能力的评估的重大转变，并充当了里程碑与临床实践之间的桥梁。每当对任何系统进行重大变革时，预计都会遇到变革阻力。已经提出了许多变革管理模型来克服这种阻力；一书中概述了一种更新的模型。目的是描述用于实施EPA的变革管理原则。
以[具体文献]中介绍的模型为框架，在威斯康星大学医院和诊所的外科与急诊医学（EM）部门共同努力下实施创伤复苏EPA。急诊医学部运用变革管理原则，完成了295次创伤复苏的教员评估，而外科部的教员在2018年7月至2019年10月的研究期间完成了50次评估。2019年冬季对急诊医学教员进行的一项调查用于确定成功实施的最重要原则。
35名急诊医学教员中有27名（回复率78%）认为[具体文献]中的关键概念对成功实施起到了重要作用。对外科部使用的实施方法进行的内部讨论确定了一些局限性，而使用这些相同的变革管理原则本可以克服这些局限性。
我们得出结论，变革管理原则为在GME中成功实施EPA提供了一个有用的框架。
