Perspectives on Involving Patients in the Teaching and Assessment of Entrustable Professional Activities in Competence by Design.

BACKGROUND

Involving patients in teaching and assessing entrustable professional activities (EPAs) within competency-based medical education (CBME) enhances the authenticity of postgraduate medical education and helps develop learners' skills. However, CBME, including Competence by Design in Canada, lacks clear guidance on involving patients. This study examines faculty members' perspectives on involving patients in teaching and assessing EPAs.

METHODS

We conducted semistructured interviews with 25 faculty members from 14 Canadian medical schools across eight residency specialties. We asked participants how they envisioned patients being involved in teaching and assessing EPAs during EPA creation, how they thought patients could contribute to teaching and assessing EPAs, and what they perceived as barriers. We analysed the data thematically.

FINDINGS

Faculty members view patients as subjects for teaching EPAs rather than as teachers of EPAs. However, they noted that patients can teach aspects of EPAs through storytelling, if provided the opportunity. They recognized the value of patients as assessors, particularly in formative assessments of learners' nontechnical skills embedded within EPAs. Nevertheless, they expressed concerns about patient involvement in summative assessments and a lack of EPAs focusing on skills that patients can assess. They noted several barriers to involving patients in teaching and assessing EPAs.

CONCLUSION

Our study underscores the pressing need for change and the crucial role of more explicit guidance on involving patients in teaching and assessing EPAs. This is not just a matter of academic interest, but a step towards enhancing the quality of medical education.