Araştırma Makalesi
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Developing Entrustable Professional Activities for Infectious Diseases Training: Lessons from the COVID-19 Pandemic

Yıl 2026, Cilt: 25 Sayı: 75 , 44 - 56 , 29.04.2026
https://doi.org/10.25282/ted.1759522
https://izlik.org/JA33SL53DG

Öz

Background: Despite the COVID-19 pandemic being a global catastrophe, it provided substantial experience to inform infectious diseases residency training. Examining these experiences through contemporary medical education approaches and deriving future educational insights appears to be essential.
Objectives: This study addresses this need within a Competency‐Based Medical Education framework by developing Entrustable Professional Activities (EPAs), along with associated competencies and entrustment information sources. These are specifically tailored to infectious diseases residency training and grounded in real‐world experiences of physicians engaged in COVID‐19 interventions.
Methods: A two-phase qualitative design was used. In phase one, expert interviews were conducted with frontline pandemic physicians. Data were analyzed using the Documentary Method, a reconstructive approach capturing not just what professionals say but how they frame and interpret their experiences. In phase two, findings informed the development of an EPA-Competency Matrix for infectious diseases training.
Results: Four core themes emerged: (1) navigating transition and uncertainty, (2) rapid learning and communication, (3) acting as public intellectuals, and (4) collaborating under extraordinary conditions. Analysis yielded 3 EPA titles and 3 nested EPAs, each with specified knowledge, skills, and attitudes. These were incorporated into the EPA-Competency Matrix with recommendations for entrustment decision sources.
Conclusion: This research presents a practice-informed EPA framework aimed at enhancing pandemic preparedness within infectious diseases training. By integrating physician narratives with educational design, it effectively connects clinical realities with curricular development, providing practical guidance for competency-based medical education. Furthermore, it can be modified for application in other specialties that may encounter future global health crises.

Kaynakça

  • 1. Betthäuser BA, Bach-Mortensen A, Engzell P. A systematic review and meta-analysis of the impact of the COVID-19 pandemic on learning. Nat Hum Behav. 2022; doi:10.1038/s41562-022-01506-4
  • 2. König C & Frey A. The Impact of COVID-19-Related School Closures on Student Achievement—A Meta-Analysis. Educational Measurement: Issues and Practice. 2022; doi:10.1111/emip.12495
  • 3. Daniel M, Gordon M, Patricio M, Hider A, Pawlik C, Bhagdev R, et al. An update on developments in medical education in response to the COVID-19 pandemic: a BEME scoping review: BEME Guide No 64. Med Teacher. 2021; doi:10.1080/0142159X.2020.1864310
  • 4. Bingham K. Plan now to speed vaccine supply for future pandemics. Nature–World View. 2020; doi:10.1038/d41586-020-02798-0
  • 5. Tollefson J. Why deforestation and extinctions make pandemics more likely. Nature-News. 2020; doi:10.1038/d41586-020-02341-1
  • 6. Frank J, Mungroo R, Ahmad Y, Wang M, Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010; doi:10.3109/0142159X.2010.500898
  • 7. Shah N, Desai C, Jorwekar G, Badyal D, Singh T. Competency-based medical education: An overview and application in pharmacology. Indian J Pharmacol. 2016; doi:10.4103/0253-7613.193312
  • 8. ten Cate O. Competency-Based Postgraduate Medical Education: Past, Present and Future. GMS J Med Educ. 2017; doi:10.3205/zma001146
  • 9. Englander R, Frank JR, Carraccio C, Sherbino J, Ross S, Snell L & on behalf of the ICBME Collaborators. Toward a shared language for competency-based medical education, Medical Teacher. 2017; doi:10.1080/0142159X.2017.1315066
  • 10. Frank J, Snell LS, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice, Medical Teacher, 2010; doi:10.3109/0142159X.2010.501190
  • 11. ten Cate O. Entrustability of professional activities and competency-based training. Medical Education. 2005; doi:10.1111/j.1365-2929.2005.02341.x
  • 12. ten Cate O, Schumacher DJ. (2022). Entrustable professional activities versus competencies and skills: Exploring why different concepts are often conflated. Adv in Health Sci Educ. 2022; doi:10.1007/s10459-022-10098-7
  • 13. 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, Medical Teacher. 2015; doi:10.3109/0142159X.2015.1060308
  • 14. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002; doi:10.1001/jama.287.2.226
  • 15. Gummesson C, Alm S, Cederborg A. et al. Entrustable professional activities (EPAs) for undergraduate medical education – development and exploration of social validity. BMC Med Educ. 2023; doi:10.1186/s12909-023-04621-6
  • 16. Berberat PO, Rotthoff T, Baerwald C, Ehrhardt M, Huenges B, Johannink J, et al. Entrustable Professional Activities in final year undergraduate medical training – advancement of the final year training logbook in Germany. GMS J Med Educ. 2019; doi:10.3205/zma001278
  • 17. Schick K, Eissner A, Wijnen-Meijer M, Johannink J, Huenges B, Ehrhardt M et al. Implementing a logbook on entrustable professional activities in the final year of undergraduate medical education in Germany – a multicentric pilot study. GMS J Med Educ. 2019; doi:10.3205/zma001277
  • 18. Czeskleba A, Holzhausen Y, Peters H. Patient safety during final-year clerkships: A qualitative study of possible error sources and of the potential of Entrustable Professional Activities. GMS J Med Educ. 2019; doi:10.3205/zma001226
  • 19. ten Cate O, Carraccio C, Damodaran A, Gofton W, Hamstra SJ, Hart DE et al. Entrustment Decision Making: Extending Miller's Pyramid. Academic Medicine. 2021; doi:10.1097/ACM.0000000000003800
  • 20. Holzhausen Y, Maaz A, Renz A, Bosch J, Peters H. Development of Entrustable Professional Activities for entry into residency at the Charité Berlin. GMS J Med Educ. 2019; doi:10.3205/zma001213
  • 21. Moll-Khosrawi P, Ganzhorn A, Zöllner C, Schulte-Uentrop L. Development and validation of a postgraduate anaesthesiology core curriculum based on Entrustable Professional Activities: a Delphi study. GMS J Med Educ. 2020; doi:10.3205/zma001345
  • 22. Meuser M & Nagel U. The expert interview and changes in knowledge production. In Bogner A, Littig B & Menz W, editors. Interviewing experts. Palgrave MacMillan; 2009. p. 17-42.
  • 23. Bohnsack R. Documentary method. In Flick U, editor. The Sage handbook of qualitative data analyses. Sage Publications; 2014. p. 217-233.
  • 24. Nohl A-M & Ofner US. Migration and ethnicity in documentary interpretation: Perspectives from a project on highly qualified migrants. In Bohnsack R, Pfaff N & Weller W, editors. Qualitative analysis and documentary method in international educational research. Barbara Budrich Publishers; 2010. p.237- 264.
  • 25. Nohl A-M. Narrative interview and documentary interpretation. In Bohnsack R, Pfaff N & Weller W, editors. Qualitative analysis and documentary method in international educational research. Barbara Budrich Publishers; 2010. p.195-217.
  • 26. Bohnsack R, Nohl A-M. Youth culture as practical innovation: Turkish German youth, “Time Out” and the actionisms of breakdance. European Journal of Cultural Studies. 2003; doi:10.1177/13675494030063006
  • 27. Glaser BG & Strauss AL. The discovery of grounded theory: Strategies for qualitative research. AldineTransaction-A Division of Transaction Publishers; 2006.
  • 28. ten Cate O & Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140, Medical Teacher. 2021; doi:10.1080/0142159X.2020.1838465
  • 29. O'Dowd E, Lydon S, O'Connor P, Madden C, Byrne D. A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011-2018. Med Educ. 2019;53(3):234-249. doi:10.1111/medu.13792
  • 30. Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923-1958. doi:10.1016/S0140-6736(10)61854-5
  • 31. Frank JR, Snell L, Sherbino J (eds.). CanMEDS 2015 Physician Competency Framework. Royal College of Physicians and Surgeons of Canada; 2015.
  • 32. Ali, S. Combatting Against Covid-19 & Misinformation: A Systematic Review. Hu Arenas 5, 337–352 (2022). https://doi.org/10.1007/s42087-020-00139-1
  • 33. Xiang D, Lehmann LS. Confronting the misinformation pandemic. Health Policy Technol. 2021;10(3):100520. doi:10.1016/j.hlpt.2021.100520
  • 34. Brown DR, Moeller JJ, Grbic D, et al. Entrustment Decision Making in the Core Entrustable Professional Activities: Results of a Multi-Institutional Study. Acad Med. 2022;97(4):536-543. doi:10.1097/ACM.0000000000004242
  • 35. Mylopoulos M, Kulasegaram K, Woods NN. Developing the experts we need: Fostering adaptive expertise through education. J Eval Clin Pract. 2018;24(3):674-677. doi:10.1111/jep.12905
  • 36. Cutrer WB, Miller B, Pusic MV, et al. Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education. Acad Med. 2017;92(1):70-75. doi:10.1097/ACM.0000000000001323

Enfeksiyon Hastalıkları Eğitimine Yönelik Devredilebilir Mesleki Etkinlikler: COVID-19 Pandemisinden Çıkarılan Dersler

Yıl 2026, Cilt: 25 Sayı: 75 , 44 - 56 , 29.04.2026
https://doi.org/10.25282/ted.1759522
https://izlik.org/JA33SL53DG

Öz

Arka plan: COVID-19 pandemisi küresel bir felaket olmakla birlikte, enfeksiyon hastalıkları uzmanlık eğitimine önemli deneyimler kazandırdığı söylenebilir. Bu deneyimleri güncel tıp eğitimi yaklaşımları ışığında incelemek ve geleceğe yönelik eğitimsel çıkarımlar elde etmek önemli görünmektedir.
Amaç: Bu çalışma, Yeterlik Temelli Tıp Eğitimi çerçevesinde, COVID-19 müdahalelerine katılan hekimlerin gerçek dünya deneyimlerine dayalı olarak enfeksiyon hastalıkları uzmanlık eğitimi için Devredilebilir Mesleki Etkinlikler (Entrustable Professional Activites - EPA) geliştirmeyi amaçlamaktadır.
Yöntem: Çalışmada iki aşamalı nitel bir tasarım benimsenmiştir. Birinci aşamada pandemi sürecinde görev yapan hekimlerle uzman görüşmeleri yapıldı. Bu görüşmeler, uzmanların kendi deneyimlerini nasıl çerçevelediklerini ve yorumladıklarını açığa çıkaran rekonstrüktif bir yaklaşım olan Belgesel Yöntem ile analiz edildi. İkinci aşamada, elde edilen bulgular, enfeksiyon hastalıkları eğitimi için bir EPA–Yeterlik Matrisi oluşturmak üzere kullanıldı.
Bulgular: Uzman hekimlerin anlatılarından dört temel tema ortaya çıktı: 1) Geçiş evresi ve belirsizlikle başa çıkma, 2) Hızlı öğrenme ve etkili iletişim, 3) Kamusal aydın olarak rol üstlenme, 4) Olağanüstü koşullarda iş birliği yapma. Analiz sonucunda her biri belirli bilgi, beceri ve tutumları içeren 3 temel EPA başlığı tanımlandı. Bu EPA’lar, EPA karar kaynaklarına yönelik önerilerle birlikte EPA–Yeterlik Matrisine dahil edildi.
Sonuç: Bu araştırma, enfeksiyon hastalıkları eğitiminde yeni pandemilere yönelik hazırlıkları güçlendirmeyi hedefleyen, gerçek uygulamalardan beslenen bir EPA çerçevesi sunmaktadır. Hekimlerin pandemi deneyimlerine ilişkin anlatıları, güncel eğitim kavramlarıyla harmanlanarak bütünleştirilmektedir. Bu bakış açısı, başka uzmanlık alanları için de uygulanabilirdir.

Kaynakça

  • 1. Betthäuser BA, Bach-Mortensen A, Engzell P. A systematic review and meta-analysis of the impact of the COVID-19 pandemic on learning. Nat Hum Behav. 2022; doi:10.1038/s41562-022-01506-4
  • 2. König C & Frey A. The Impact of COVID-19-Related School Closures on Student Achievement—A Meta-Analysis. Educational Measurement: Issues and Practice. 2022; doi:10.1111/emip.12495
  • 3. Daniel M, Gordon M, Patricio M, Hider A, Pawlik C, Bhagdev R, et al. An update on developments in medical education in response to the COVID-19 pandemic: a BEME scoping review: BEME Guide No 64. Med Teacher. 2021; doi:10.1080/0142159X.2020.1864310
  • 4. Bingham K. Plan now to speed vaccine supply for future pandemics. Nature–World View. 2020; doi:10.1038/d41586-020-02798-0
  • 5. Tollefson J. Why deforestation and extinctions make pandemics more likely. Nature-News. 2020; doi:10.1038/d41586-020-02341-1
  • 6. Frank J, Mungroo R, Ahmad Y, Wang M, Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010; doi:10.3109/0142159X.2010.500898
  • 7. Shah N, Desai C, Jorwekar G, Badyal D, Singh T. Competency-based medical education: An overview and application in pharmacology. Indian J Pharmacol. 2016; doi:10.4103/0253-7613.193312
  • 8. ten Cate O. Competency-Based Postgraduate Medical Education: Past, Present and Future. GMS J Med Educ. 2017; doi:10.3205/zma001146
  • 9. Englander R, Frank JR, Carraccio C, Sherbino J, Ross S, Snell L & on behalf of the ICBME Collaborators. Toward a shared language for competency-based medical education, Medical Teacher. 2017; doi:10.1080/0142159X.2017.1315066
  • 10. Frank J, Snell LS, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice, Medical Teacher, 2010; doi:10.3109/0142159X.2010.501190
  • 11. ten Cate O. Entrustability of professional activities and competency-based training. Medical Education. 2005; doi:10.1111/j.1365-2929.2005.02341.x
  • 12. ten Cate O, Schumacher DJ. (2022). Entrustable professional activities versus competencies and skills: Exploring why different concepts are often conflated. Adv in Health Sci Educ. 2022; doi:10.1007/s10459-022-10098-7
  • 13. 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, Medical Teacher. 2015; doi:10.3109/0142159X.2015.1060308
  • 14. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002; doi:10.1001/jama.287.2.226
  • 15. Gummesson C, Alm S, Cederborg A. et al. Entrustable professional activities (EPAs) for undergraduate medical education – development and exploration of social validity. BMC Med Educ. 2023; doi:10.1186/s12909-023-04621-6
  • 16. Berberat PO, Rotthoff T, Baerwald C, Ehrhardt M, Huenges B, Johannink J, et al. Entrustable Professional Activities in final year undergraduate medical training – advancement of the final year training logbook in Germany. GMS J Med Educ. 2019; doi:10.3205/zma001278
  • 17. Schick K, Eissner A, Wijnen-Meijer M, Johannink J, Huenges B, Ehrhardt M et al. Implementing a logbook on entrustable professional activities in the final year of undergraduate medical education in Germany – a multicentric pilot study. GMS J Med Educ. 2019; doi:10.3205/zma001277
  • 18. Czeskleba A, Holzhausen Y, Peters H. Patient safety during final-year clerkships: A qualitative study of possible error sources and of the potential of Entrustable Professional Activities. GMS J Med Educ. 2019; doi:10.3205/zma001226
  • 19. ten Cate O, Carraccio C, Damodaran A, Gofton W, Hamstra SJ, Hart DE et al. Entrustment Decision Making: Extending Miller's Pyramid. Academic Medicine. 2021; doi:10.1097/ACM.0000000000003800
  • 20. Holzhausen Y, Maaz A, Renz A, Bosch J, Peters H. Development of Entrustable Professional Activities for entry into residency at the Charité Berlin. GMS J Med Educ. 2019; doi:10.3205/zma001213
  • 21. Moll-Khosrawi P, Ganzhorn A, Zöllner C, Schulte-Uentrop L. Development and validation of a postgraduate anaesthesiology core curriculum based on Entrustable Professional Activities: a Delphi study. GMS J Med Educ. 2020; doi:10.3205/zma001345
  • 22. Meuser M & Nagel U. The expert interview and changes in knowledge production. In Bogner A, Littig B & Menz W, editors. Interviewing experts. Palgrave MacMillan; 2009. p. 17-42.
  • 23. Bohnsack R. Documentary method. In Flick U, editor. The Sage handbook of qualitative data analyses. Sage Publications; 2014. p. 217-233.
  • 24. Nohl A-M & Ofner US. Migration and ethnicity in documentary interpretation: Perspectives from a project on highly qualified migrants. In Bohnsack R, Pfaff N & Weller W, editors. Qualitative analysis and documentary method in international educational research. Barbara Budrich Publishers; 2010. p.237- 264.
  • 25. Nohl A-M. Narrative interview and documentary interpretation. In Bohnsack R, Pfaff N & Weller W, editors. Qualitative analysis and documentary method in international educational research. Barbara Budrich Publishers; 2010. p.195-217.
  • 26. Bohnsack R, Nohl A-M. Youth culture as practical innovation: Turkish German youth, “Time Out” and the actionisms of breakdance. European Journal of Cultural Studies. 2003; doi:10.1177/13675494030063006
  • 27. Glaser BG & Strauss AL. The discovery of grounded theory: Strategies for qualitative research. AldineTransaction-A Division of Transaction Publishers; 2006.
  • 28. ten Cate O & Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140, Medical Teacher. 2021; doi:10.1080/0142159X.2020.1838465
  • 29. O'Dowd E, Lydon S, O'Connor P, Madden C, Byrne D. A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011-2018. Med Educ. 2019;53(3):234-249. doi:10.1111/medu.13792
  • 30. Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923-1958. doi:10.1016/S0140-6736(10)61854-5
  • 31. Frank JR, Snell L, Sherbino J (eds.). CanMEDS 2015 Physician Competency Framework. Royal College of Physicians and Surgeons of Canada; 2015.
  • 32. Ali, S. Combatting Against Covid-19 & Misinformation: A Systematic Review. Hu Arenas 5, 337–352 (2022). https://doi.org/10.1007/s42087-020-00139-1
  • 33. Xiang D, Lehmann LS. Confronting the misinformation pandemic. Health Policy Technol. 2021;10(3):100520. doi:10.1016/j.hlpt.2021.100520
  • 34. Brown DR, Moeller JJ, Grbic D, et al. Entrustment Decision Making in the Core Entrustable Professional Activities: Results of a Multi-Institutional Study. Acad Med. 2022;97(4):536-543. doi:10.1097/ACM.0000000000004242
  • 35. Mylopoulos M, Kulasegaram K, Woods NN. Developing the experts we need: Fostering adaptive expertise through education. J Eval Clin Pract. 2018;24(3):674-677. doi:10.1111/jep.12905
  • 36. Cutrer WB, Miller B, Pusic MV, et al. Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education. Acad Med. 2017;92(1):70-75. doi:10.1097/ACM.0000000000001323
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp Eğitimi
Bölüm Araştırma Makalesi
Yazarlar

Şükrü Erhan Bağcı 0000-0003-2089-8009

Gönderilme Tarihi 6 Ağustos 2025
Kabul Tarihi 27 Aralık 2025
Yayımlanma Tarihi 29 Nisan 2026
DOI https://doi.org/10.25282/ted.1759522
IZ https://izlik.org/JA33SL53DG
Yayımlandığı Sayı Yıl 2026 Cilt: 25 Sayı: 75

Kaynak Göster

Vancouver 1.Şükrü Erhan Bağcı. Developing Entrustable Professional Activities for Infectious Diseases Training: Lessons from the COVID-19 Pandemic. TED. 01 Nisan 2026;25(75):44-56. doi:10.25282/ted.1759522