Gama Alcino, Felicelli Christopher, Agarwal Indu, Bronson Taylor, Choy Bonnie, Escobar David J, Ju Jennifer Y, LaBoy Carissa, Nayar Ritu, Nezami Behtash G, Nguyen Jessica, Obeidin Farres, Purdy Jenna, Shanes Elisheva, Strickland Amanda L, Blanco Luis Z, Novo Jorge E
Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Pathology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Acad Pathol. 2024 Oct 24;11(4):100150. doi: 10.1016/j.acpath.2024.100150. eCollection 2024 Oct-Dec.
Entrustable professional activities (EPAs) have been implemented in various medical specialties, and the Pathology National EPA Working Group has piloted the implementation of four pathology EPAs. We recently published the development of EPAs within our surgical pathology rotation. Following a six-month pilot, a survey demonstrated that faculty and residents found the forms helpful and easy to use and easy to understand, and EPAs have been fully incorporated into our surgical pathology rotation. Here, we discuss our experience, challenges, and results of resident EPA performance for intraoperative consultations (IOC) and sign-out (SO) after 21 months of implementation. Between June 2022 and March 2024, 24 residents were evaluated by 13 faculty members, resulting in 136 IOC and 298 SO EPA forms. Paper forms were predominantly used, with only five electronic forms submitted. EPA performance scores for SO increased from 2.4 ± 0.8 in Block 1 to 4.6 ± 0.2 in Block 14 (p < 0.0001), whereas performance scores for IOC increased from 2.7 ± 1.0 in Block 1 to 4.8 ± 0.2 in Block 14 (p < 0.0001). The progressive decrease in the standard deviation throughout residency denotes higher competence homogeneity as residency graduation approaches. Overall, our EPA evaluation method showed ease of use, provided valuable tracking tools, and long-term feasibility. EPAs are robust tools for tracking resident progression toward independent practice in surgical pathology, offering valuable insights for program and rotation directors to assess and track individual EPA skills, identify intervention points, and provide an opportunity for immediate, actionable feedback based on current performance.
可托付专业活动（EPA）已在多个医学专业中实施，病理学国家EPA工作组已试点实施了四项病理学EPA。我们最近发表了关于外科病理学轮转中EPA的发展情况。经过为期六个月的试点，一项调查表明，教员和住院医师发现这些表格很有用，易于使用且易于理解，并且EPA已完全纳入我们的外科病理学轮转中。在此，我们讨论在实施21个月后，住院医师在术中会诊（IOC）和签出（SO）方面的EPA表现的经验、挑战和结果。在2022年6月至2024年3月期间，13名教员对24名住院医师进行了评估，共产生了136份IOC和298份SO EPA表格。主要使用纸质表格，仅提交了五份电子表格。SO的EPA表现评分从第1阶段的2.4±0.8提高到第14阶段的4.6±0.2（p<0.0001），而IOC的表现评分从第1阶段的2.7±1.0提高到第14阶段的4.8±0.2（p<0.0001）。在整个住院医师培训期间，标准差的逐渐降低表明随着住院医师培训毕业临近，能力同质性更高。总体而言，我们的EPA评估方法显示出易于使用，提供了有价值的跟踪工具，并且具有长期可行性。EPA是跟踪住院医师在外科病理学中向独立执业发展的有力工具，为项目和轮转主任提供了有价值的见解，以评估和跟踪个人的EPA技能，确定干预点，并根据当前表现提供即时、可操作反馈机会。
