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Klinik Yeterlilikte Devredilebilir Mesleksel Etkinlikler

Year 2024, , 5 - 14, 30.04.2024
https://doi.org/10.25282/ted.1362961

Abstract

Amaç: Son yıllarda Devredilebilir Mesleksel Etkinlikler (DME), çağdaş tıp eğitiminin önemli bir bileşeni haline gelen Yetkinliğe Dayalı Tıp Eğitimi (YDTE) uygulaması için temel bir çerçeve olarak gelişmiştir. Sağlık mesleği eğitimi, sağlık hizmeti sunumu ve toplumsal talepler arasındaki açığı kapatma ihtiyacı, YDTE’e geçişi motive etmektedir. Yetkinlikler tıp profesyonellerinin sahip olması gereken özellikleri tanımlarken, DME’ler öğrencilerin tıp eğitimlerinde ve gelecekteki kariyerlerinde gerçekleştirmeleri beklenen pratik faaliyetleri tanımlamaktadır. Soyut becerileri gerçek dünyada klinik uygulamaya dönüştürmenin zorluğu, yetkinlik gösterdikten sonra öğrencilere devredilebilecek belirli faaliyetler veya sorumluluklar olan DME’lerin geliştirilmesini teşvik etmiştir. Devredilebilir Mesleksel Etkinliklerin kullanılmaya başlanmasıyla tıp eğitimi programları, yetkinlikleri değerlendirmenin daha etkili bir yolunu keşfetmiş ve bunları öğrencilerin gerçekleştirmesi beklenen mesleki görevlerle uyumlu hale getirmiştir. Bu uyum, amaçlanan yetkinlikler ile gerçek dünyadaki uygulamalar arasında anlamlı bir bağlantı kurulmasını sağlayarak geleceğin tıp uzmanlarının hazır olma durumunu iyileştirmektedir.
Yöntem: Makale geleneksel derleme yöntemiyle hazırlanmıştır.
Bulgular: Bu makale, Devredilebilir Mesleksel Etkinliklerin belirli özelliklerini ve yetkinlik temelli değerlendirmelerin gerçek klinik durumlara dayandırılmasının önemini vurgulamaktadır. DME’ler, öğrencilerin aşamalı olarak ilerlemesini sağlayarak zaman içinde hazırlıklı olmanın yanı sıra sorumluluğu da teşvik eder. Teknolojinin DME’lere dahil edilmesinin hem öğretimi hem de öğrenimi nasıl geliştirme potansiyeline sahip olduğu tartışılmaktadır. Teknolojik destek ve mobil uygulamaların kullanımı DME’leri hem öğretim üyeleri hem de öğrenciler için daha uygulanabilir ve anlaşılır hale getirebilir.
Sonuç: Yetkinliğe Dayalı Tıp Eğitimi ve Devredilebilir Mesleksel Etkinlikler’in entegrasyonu, tıp eğitiminin etkinliği konusundaki endişeleri gidermek için umut verici bir stratejidir. DME’ler, gerçek dünyadaki görevlerle aktif olarak ilgilenerek, yetkinliklerin öğrenciler tarafından içselleştirilmesini kolaylaştırır geleneksel yetkinlik çerçevelerinden farklı olarak, nitelikler yerine eylemleri vurgulayarak değerlendirme ve ölçmeyi daha somut ve yerinde hale getirir. DME’ler, yetkinlik değerlendirmesine yapılandırılmış, uyarlanabilir ve bağlama özgü bir yaklaşım sunarak, öğrencilerin aşamalı olarak sorumluluk üstlenmelerini sağlar ve böylece yetkin ve kendine güvenen sağlık uzmanları olma yollarını kolaylaştırır. Tıp eğitimi programları, DME’lerin ve yetkinliklerin tamamlayıcı doğasını kabul ederek, teorik bilgi ve pratik klinik beceriler arasındaki boşlukları dolduran kapsamlı ve etkili eğitim teknikleri geliştirebilir.

References

  • 1. Association of American Medical Colleges (AAMC) [Internet]. 2023 [cited 2023 Aug 1]. Competency-Based Medical Education (CBME). Available from: https://www.aamc.org/about-us/mission-areas/medical-education/cbme
  • 2. Ten Cate O. Entrustable Professional Activities as a Framework for the Assessment of Residents, ACGME Annual Educational Conference. In: Cate Ten olle, editor. Entrustable Professional Activities as a Framework for the Assessment of Residents. 2015.
  • 3. Cate O ten. An Updated Primer on Entrustable Professional Activities (EPAs). Rev Bras Educ Med. 2019;43(1 suppl 1):712–20.
  • 4. Kwan J, Crampton R, Mogensen LL, Weaver R, Van Der Vleuten CPM, Hu WCY. Bridging the gap: A five stage approach for developing specialty-specific entrustable professional activities. BMC Med Educ. 2016 Apr 20;16(1).
  • 5. ten Cate O. Competency-Based Education, Entrustable Professional Activities, and the Power of Language. J Grad Med Educ. 2013 Mar 1;5(1):6–7.
  • 6. Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: A systematic review of published definitions. Med Teach. 2010 Aug;32(8):631–7.
  • 7. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Ttransforming education to strengthen health systems in an interdependent world. Vol. 376, The Lancet. Elsevier B.V.; 2010. p. 1923–58.
  • 8. Modi J GPST. Competency-based Medical Education, Entrustment and Assessment. Indian Pediatr. 2015 May 15;52:413–20.
  • 9. Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting Paradigms: From Flexner to Competencies. Acad Med. 2002 May;77(5):361–7.
  • 10. Altıntaş Levent. Mezuniyet Sonrası Dönemde Ölçme ve Değerlendirmenin Tasarımında Devredilebilir Mesleksel Etkinliklerin Önemi. Turkiye Klinikleri J Med Educ-Special Topics. 2016;1(2):31–7.
  • 11. Hauer Karen E, Chen H, Young J, O’Sullivan P. Defining and assesing Entrustable Professional Activities [Internet]. 2013 [cited 2023 Aug 1]. Available from: https://slidetodoc.com/defining-and-assessing-entrustable-professional-activities-karen-e/
  • 12. Ten Cate O, Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140. Med Teach. 2021;43(10):1106–14.
  • 13. Ten Cate O. Entrustability of professional activities and competency-based training. Vol. 39, Medical Education. 2005. p. 1176–7.
  • 14. Ten Cate O, Scheele F. Viewpoint: Competency-Based Postgraduate Training: Can We Bridge the Gap between Theory and Clinical Practice? Academic Medicine. 2007;82(6):542–7.
  • 15. Ten Cate O, Chen HC, Hoff RG, Peters H,   Bok H, Van Der Schaaf M. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99. Med Teach. 2015 Nov 2;37(11):983–1002.
  • 16. Peters H, Holzhausen Y, Boscardin C, ten Cate O, Chen HC. Twelve tips for the implementation of EPAs for assessment and entrustment decisions. Med Teach. 2017 Aug 3;39(8):802–7.
  • 17. ten Cate O, Hoff RG. From case-based to entrustment-based discussions. Clinical Teacher. 2017 Dec 1;14(6):385–9.
  • 18. Kennedy TJT, Regehr G, Baker GR, Lingard L. Point-of-Care Assessment of Medical Trainee Competence for Independent Clinical Work. 19. ten Cate O. Nuts and Bolts of Entrustable Professional Activities. J Grad Med Educ. 2013 Mar 1;5(1):157–8.
  • 20. Cate O Ten, Hart D, Ankel F, Busari J, Englander R, Glasgow N, et al. Entrustment Decision Making in Clinical Training. Academic Medicine. 2016 Feb 1;91(2):191–8.
  • 21. Upreet Dhaliwal, Pıyush Gupta, Tejinder Sing. Entrustable Professional Activities: Teaching and Assessing Clinical Competence. Indian Journals. 2015 Jul 15;52:591–7.
  • 22. Mulder H, Cate O Ten, Daalder R, Berkvens J. Building a competency-based workplace curriculum around entrustable professional activities: The case of physician assistant training. Med Teach. 2010 Oct;32(10).
  • 23. Marty AP, Linsenmeyer M, George B, Young JQ, Breckwoldt J, ten Cate O. Mobile technologies to support workplace-based assessment for entrustment decisions: guidelines for programs and educators: AMEE Guide No. 154. Med Teach. 2023; 45(11):1203-1213.

Entrustable Professional Activites for Clinical Competence

Year 2024, , 5 - 14, 30.04.2024
https://doi.org/10.25282/ted.1362961

Abstract

Aim: In recent years Entrustable Professional Activities (EPAs) have developed as an essential framework for competency-based medical education (CBME) implementation, which has become an important component of contemporary medical education. The need to close the gap between healthcare professional education, healthcare delivery, and societal demands motivates the transition to CBME. While the competencies describe the attributes that medical professionals should possess, the EPAs describe the practical activities that learners are expected to perform in their medical education and future careers. The difficulty of translating abstract abilities into clinical practice in the real world encouraged the development of EPAs, which are specific activities or responsibilities that may be delegated to learners upon demonstrating competency. With the introduction of EPAs, medical education programs have discovered a more effective means of assessing competencies that aligns them with the professional tasks that students are expected to perform. This alignment promotes a meaningful connection between intended competencies and real-world practice, which ultimately improves the readiness of future medical professionals.
Methods: The article was prepared by the traditional review method.
Results: This article highlights the particular features of EPAs and the significance of competency-based assessments being grounded in actual clinical situations. EPAs enable learners to advance progressively, fostering preparedness as well as responsibility over time. It is discussed how the incorporation of technology into EPAs has the potential to improve both teaching and learning. The use of technological support and mobile applications can make EPAs more applicable and comprehensible to both faculty and students.
Conclusions: The integration of CBME and EPAs is a promising strategy for addressing concerns about medical education’s effectiveness. By actively engaging in real-world tasks, EPAs facilitate the internalization of competencies by learners. By providing a structured, adaptable, and context-specific approach to competency assessment, EPAs enable learners to assume responsibilities progressively, thereby facilitating their path to becoming competent and confident healthcare professionals.
By recognizing the complementary nature of EPAs and competences, medical education programs can develop thorough and efficient training techniques that bridge the gaps between theoretical knowledge and practical clinical abilities.

References

  • 1. Association of American Medical Colleges (AAMC) [Internet]. 2023 [cited 2023 Aug 1]. Competency-Based Medical Education (CBME). Available from: https://www.aamc.org/about-us/mission-areas/medical-education/cbme
  • 2. Ten Cate O. Entrustable Professional Activities as a Framework for the Assessment of Residents, ACGME Annual Educational Conference. In: Cate Ten olle, editor. Entrustable Professional Activities as a Framework for the Assessment of Residents. 2015.
  • 3. Cate O ten. An Updated Primer on Entrustable Professional Activities (EPAs). Rev Bras Educ Med. 2019;43(1 suppl 1):712–20.
  • 4. Kwan J, Crampton R, Mogensen LL, Weaver R, Van Der Vleuten CPM, Hu WCY. Bridging the gap: A five stage approach for developing specialty-specific entrustable professional activities. BMC Med Educ. 2016 Apr 20;16(1).
  • 5. ten Cate O. Competency-Based Education, Entrustable Professional Activities, and the Power of Language. J Grad Med Educ. 2013 Mar 1;5(1):6–7.
  • 6. Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: A systematic review of published definitions. Med Teach. 2010 Aug;32(8):631–7.
  • 7. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Ttransforming education to strengthen health systems in an interdependent world. Vol. 376, The Lancet. Elsevier B.V.; 2010. p. 1923–58.
  • 8. Modi J GPST. Competency-based Medical Education, Entrustment and Assessment. Indian Pediatr. 2015 May 15;52:413–20.
  • 9. Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting Paradigms: From Flexner to Competencies. Acad Med. 2002 May;77(5):361–7.
  • 10. Altıntaş Levent. Mezuniyet Sonrası Dönemde Ölçme ve Değerlendirmenin Tasarımında Devredilebilir Mesleksel Etkinliklerin Önemi. Turkiye Klinikleri J Med Educ-Special Topics. 2016;1(2):31–7.
  • 11. Hauer Karen E, Chen H, Young J, O’Sullivan P. Defining and assesing Entrustable Professional Activities [Internet]. 2013 [cited 2023 Aug 1]. Available from: https://slidetodoc.com/defining-and-assessing-entrustable-professional-activities-karen-e/
  • 12. Ten Cate O, Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140. Med Teach. 2021;43(10):1106–14.
  • 13. Ten Cate O. Entrustability of professional activities and competency-based training. Vol. 39, Medical Education. 2005. p. 1176–7.
  • 14. Ten Cate O, Scheele F. Viewpoint: Competency-Based Postgraduate Training: Can We Bridge the Gap between Theory and Clinical Practice? Academic Medicine. 2007;82(6):542–7.
  • 15. Ten Cate O, Chen HC, Hoff RG, Peters H,   Bok H, Van Der Schaaf M. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99. Med Teach. 2015 Nov 2;37(11):983–1002.
  • 16. Peters H, Holzhausen Y, Boscardin C, ten Cate O, Chen HC. Twelve tips for the implementation of EPAs for assessment and entrustment decisions. Med Teach. 2017 Aug 3;39(8):802–7.
  • 17. ten Cate O, Hoff RG. From case-based to entrustment-based discussions. Clinical Teacher. 2017 Dec 1;14(6):385–9.
  • 18. Kennedy TJT, Regehr G, Baker GR, Lingard L. Point-of-Care Assessment of Medical Trainee Competence for Independent Clinical Work. 19. ten Cate O. Nuts and Bolts of Entrustable Professional Activities. J Grad Med Educ. 2013 Mar 1;5(1):157–8.
  • 20. Cate O Ten, Hart D, Ankel F, Busari J, Englander R, Glasgow N, et al. Entrustment Decision Making in Clinical Training. Academic Medicine. 2016 Feb 1;91(2):191–8.
  • 21. Upreet Dhaliwal, Pıyush Gupta, Tejinder Sing. Entrustable Professional Activities: Teaching and Assessing Clinical Competence. Indian Journals. 2015 Jul 15;52:591–7.
  • 22. Mulder H, Cate O Ten, Daalder R, Berkvens J. Building a competency-based workplace curriculum around entrustable professional activities: The case of physician assistant training. Med Teach. 2010 Oct;32(10).
  • 23. Marty AP, Linsenmeyer M, George B, Young JQ, Breckwoldt J, ten Cate O. Mobile technologies to support workplace-based assessment for entrustment decisions: guidelines for programs and educators: AMEE Guide No. 154. Med Teach. 2023; 45(11):1203-1213.
There are 22 citations in total.

Details

Primary Language English
Subjects Medical Education
Journal Section Review
Authors

Duygu Demirbaş Keskin 0000-0002-4162-2442

Demet Koç 0000-0003-4109-6793

Levent Altıntaş 0000-0002-4950-6956

Publication Date April 30, 2024
Submission Date September 20, 2023
Published in Issue Year 2024

Cite

Vancouver Demirbaş Keskin D, Koç D, Altıntaş L. Entrustable Professional Activites for Clinical Competence. TED. 2024;23(69):5-14.