Competency-based medical education across the continuum: How well aligned are medical school EPAs to residency milestones?

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Bibliographic Details
Title: Competency-based medical education across the continuum: How well aligned are medical school EPAs to residency milestones?
Authors: Ryan, Michael S.1, Iobst, William2, Holmboe, Eric S.2, Santen, Sally A.3
Source: Medical Teacher. May2022, Vol. 44 Issue 5, p510-518. 9p.
Subject Terms: *Internship programs, *Undergraduate programs, *Outcome-based education, *Medical schools, *Graduate education, *Clinical competence, *Interdisciplinary education, *Medical education, Physical diagnosis, Differential diagnosis, Medical history taking, Patient safety
Geographic Terms: United States
Abstract: Competency-based medical education (CBME) provides a framework for describing learner progression throughout training. However, specific approaches to CBME implementation vary widely across educational settings. Alignment between various methods used across the continuum is critical to support transitions and assess learner performance. The purpose of this study was to investigate alignment between CBME frameworks used in undergraduate medical education (UME) and graduate medical education (GME) settings using the US context as a model. The authors analyzed content from the core entrustable professional activities for entering residency (Core EPAs; UME model) and residency milestones (GME model). From that analysis, they performed a series of cross-walk activities to investigate alignment between frameworks. After independent review, authors discussed findings until consensus was reached. Some alignment was found for activities associated with history taking, physical examination, differential diagnosis, patient safety, and interprofessional care; however, there were far more examples of misalignment. These findings highlight challenges creating alignment of assessment frameworks across the continuum of training. The importance of these findings includes implications for assessment and persistence of the educational gap across UME and GME. The authors provide four next steps to improve upon the continuum of education. [ABSTRACT FROM AUTHOR]
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Database: Education Research Complete
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Abstract:Competency-based medical education (CBME) provides a framework for describing learner progression throughout training. However, specific approaches to CBME implementation vary widely across educational settings. Alignment between various methods used across the continuum is critical to support transitions and assess learner performance. The purpose of this study was to investigate alignment between CBME frameworks used in undergraduate medical education (UME) and graduate medical education (GME) settings using the US context as a model. The authors analyzed content from the core entrustable professional activities for entering residency (Core EPAs; UME model) and residency milestones (GME model). From that analysis, they performed a series of cross-walk activities to investigate alignment between frameworks. After independent review, authors discussed findings until consensus was reached. Some alignment was found for activities associated with history taking, physical examination, differential diagnosis, patient safety, and interprofessional care; however, there were far more examples of misalignment. These findings highlight challenges creating alignment of assessment frameworks across the continuum of training. The importance of these findings includes implications for assessment and persistence of the educational gap across UME and GME. The authors provide four next steps to improve upon the continuum of education. [ABSTRACT FROM AUTHOR]
ISSN:0142159X
DOI:10.1080/0142159X.2021.2004303