Departments of Surgery & Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Director of Academic Technologies, Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Med Teach. 2023 Sep;45(9):1054-1060. doi: 10.1080/0142159X.2023.2215910. Epub 2023 Jun 1.
The transition towards Competency-Based Medical Education at the Cumming School of Medicine was accelerated by the reduced clinical time caused by the COVID-19 pandemic. The purpose of this study was to define a standard protocol for setting Entrustable Professional Activity (EPA) achievement thresholds and examine their feasibility within the clinical clerkship.
Achievement thresholds for each of the 12 AFMC EPAs for graduating Canadian medical students were set by using sequential rounds of revision by three consecutive groups of stakeholders and evaluation experts. Structured communication was guided by a modified Delphi technique. The feasibility/consequence models of these EPAs were then assessed by tracking their completion by the graduating class of 2021.
The threshold-setting process resulted in set EPA achievement levels ranging from 1 to 8 across the 12 AFMC EPAs. Estimates were stable after the first round for 9 of 12 EPAs. 96.27% of EPAs were successfully completed by clerkship students despite the shortened clinical period. Feasibility was predicted by the slowing rate of EPA accumulation overtime during the clerkship.
The process described led to consensus on EPA achievement thresholds. Successful completion of the assigned thresholds was feasible within the shortened clerkship.[Box: see text].
由于 COVID-19 大流行导致临床时间减少，卡明医学院加快了向基于能力的医学教育的转变。本研究的目的是定义设定可委托专业活动 (EPA) 成就门槛的标准协议，并在临床实习中检查其可行性。
通过三批连续的利益相关者和评估专家进行的几轮修订，为即将毕业的加拿大医学生的 12 项 AFMC EPA 中的每一项确定了成就门槛。结构化沟通通过修改后的 Delphi 技术进行指导。然后通过跟踪 2021 届毕业生的完成情况来评估这些 EPA 的可行性/后果模型。
设定的门槛设定过程导致在 12 项 AFMC EPA 中，每个 EPA 的成就水平从 1 到 8 不等。在前两轮之后，12 项 EPA 中有 9 项的估计值保持稳定。尽管临床时间缩短，但实习学生成功完成了 96.27%的 EPA。可行性是由实习期间 EPA 积累速度的放缓来预测的。
所描述的过程导致了 EPA 成就门槛的共识。在缩短的实习中，成功完成分配的门槛是可行的。[方框：见文本]。
