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In EPAs we trust, is quality and safety a must? A cross-specialty analysis of entrustable professional activity guides.

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Title: In EPAs we trust, is quality and safety a must? A cross-specialty analysis of entrustable professional activity guides.
Authors: Brown, Allison1 allison.brown@ucalgary.ca, La, Julie2,3, Keri, McNiel-Inyani1, Hillis, Chris4, Razack, Saleem5, Korah, Nadine6, Karpinski, Jolanta7, Frank, Jason R.7, Wong, Brian8,9, Goldman, Joanne8,9
Source: Medical Teacher. Jan2025, Vol. 47 Issue 1, p134-142. 9p.
Subject Terms: *Medical education standards, *Graduate education, *Clinical competence, *Outcome-based education, Patient safety, Medical specialties & specialists, Research funding, Judgment sampling, Descriptive statistics, Conceptual structures, Quality assurance
Geographic Terms: Canada
Abstract: Purpose: The inclusion of quality improvement (QI) and patient safety (PS) into CanMEDS reflects an expectation that graduating physicians are competent in these areas upon training completion. To ensure that Canadian postgraduate specialty training achieves this, the translation of QI/PS competencies into training standards as part of the implementation of competency-based medical education requires special attention. Methods: We conducted a cross-specialty, multi-method analysis to examine how QI/PS was incorporated into the EPA Guides across 11 postgraduate specialties in Canada. Results: We identify cross-specialty variability in how QI/PS is incorporated, positioned, and emphasized in EPAs and milestones. QI/PS was primarily referenced alongside clinical activities rather than as a sole competency or discrete activity. Patterns were characterized in how QI/PS became incorporated into milestones through repetition and customization. QI/PS was also decoupled, conceptualized, and emphasized differently across specialties. Conclusions: Variability in the inclusion of QI/PS in EPAs and milestones has important implications considering the visibility and influence of EPA Guides in practice. As specialties revisit and revise EPA Guides, there is a need to balance the standardization of foundational QI/PS concepts to foster shared understanding while simultaneously ensuring context-sensitive applications across specialties. Beyond QI/PS, this study illuminates the challenges and opportunities that lie in bridging theoretical frameworks with practical implementation in medical education, prompting broader consideration of how intrinsic roles and emergent areas are effectively incorporated into competency-based medical education. [ABSTRACT FROM AUTHOR]
Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: In EPAs we trust, is quality and safety a must? A cross-specialty analysis of entrustable professional activity guides.
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  Data: Purpose: The inclusion of quality improvement (QI) and patient safety (PS) into CanMEDS reflects an expectation that graduating physicians are competent in these areas upon training completion. To ensure that Canadian postgraduate specialty training achieves this, the translation of QI/PS competencies into training standards as part of the implementation of competency-based medical education requires special attention. Methods: We conducted a cross-specialty, multi-method analysis to examine how QI/PS was incorporated into the EPA Guides across 11 postgraduate specialties in Canada. Results: We identify cross-specialty variability in how QI/PS is incorporated, positioned, and emphasized in EPAs and milestones. QI/PS was primarily referenced alongside clinical activities rather than as a sole competency or discrete activity. Patterns were characterized in how QI/PS became incorporated into milestones through repetition and customization. QI/PS was also decoupled, conceptualized, and emphasized differently across specialties. Conclusions: Variability in the inclusion of QI/PS in EPAs and milestones has important implications considering the visibility and influence of EPA Guides in practice. As specialties revisit and revise EPA Guides, there is a need to balance the standardization of foundational QI/PS concepts to foster shared understanding while simultaneously ensuring context-sensitive applications across specialties. Beyond QI/PS, this study illuminates the challenges and opportunities that lie in bridging theoretical frameworks with practical implementation in medical education, prompting broader consideration of how intrinsic roles and emergent areas are effectively incorporated into competency-based medical education. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1080/0142159X.2024.2323177
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      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 134
    Subjects:
      – SubjectFull: Medical education standards
        Type: general
      – SubjectFull: Graduate education
        Type: general
      – SubjectFull: Clinical competence
        Type: general
      – SubjectFull: Outcome-based education
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      – SubjectFull: Patient safety
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      – SubjectFull: Medical specialties & specialists
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      – SubjectFull: Research funding
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      – SubjectFull: Judgment sampling
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Conceptual structures
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      – SubjectFull: Quality assurance
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      – SubjectFull: Canada
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      – TitleFull: In EPAs we trust, is quality and safety a must? A cross-specialty analysis of entrustable professional activity guides.
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              Text: Jan2025
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