Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training.

Tytuł:: Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training.
Autorzy:: Woodworth GE; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.
Marty AP; Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
Tanaka PP; Department of Anesthesiology, Stanford University, Stanford, California.
Ambardekar AP; Department of Anesthesiology, University of Texas, Southwestern Medical Center, Dallas, Texas.
Chen F; Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
Duncan MJ; Department of Anesthesiology, University of Missouri-Kansas City, Kansas City, Missouri.
Fromer IR; Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota.
Hallman MR; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
Klesius LL; Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Ladlie BL; Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
Mitchell SA; Department of Anesthesiology, Indiana University, Indianapolis, Indiana.
Miller Juve AK; Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.
McGrath BJ; Department of Anesthesiology, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida.
Shepler JA; Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Sims C 3rd; Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
Spofford CM; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Van Cleve W; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
Maniker RB; Department of Anesthesiology, Columbia University, New York, New York.
Źródło:: Anesthesia and analgesia [Anesth Analg] 2021 Jun 01; Vol. 132 (6), pp. 1579-1591.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins
Original Publication: Cleveland, International Anesthesia Research Society.
MeSH Terms:: Professional Role*
Anesthesiology/*standards
Internship and Residency/*standards
Program Development/*standards
Anesthesiology/education ; Anesthesiology/trends ; Humans ; Internship and Residency/trends ; Pilot Projects ; Surveys and Questionnaires ; United States
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Entry Date(s):: Date Created: 20210304 Date Completed: 20210727 Latest Revision: 20230721
Update Code:: 20240105
DOI:: 10.1213/ANE.0000000000005434
PMID:: 33661789
: Czasopismo naukowe

Background: Modern medical education requires frequent competency assessment. The Accreditation Council for Graduate Medical Education (ACGME) provides a descriptive framework of competencies and milestones but does not provide standardized instruments to assess and track trainee competency over time. Entrustable professional activities (EPAs) represent a workplace-based method to assess the achievement of competency milestones at the point-of-care that can be applied to anesthesiology training in the United States.
Methods: Experts in education and competency assessment were recruited to participate in a 6-step process using a modified Delphi method with iterative rounds to reach consensus on an entrustment scale, a list of EPAs and procedural skills, detailed definitions for each EPA, a mapping of the EPAs to the ACGME milestones, and a target level of entrustment for graduating US anesthesiology residents for each EPA and procedural skill. The defined EPAs and procedural skills were implemented using a website and mobile app. The assessment system was piloted at 7 anesthesiology residency programs. After 2 months, faculty were surveyed on their attitudes on usability and utility of the assessment system. The number of evaluations submitted per month was collected for 1 year.
Results: Participants in EPA development included 18 education experts from 11 different programs. The Delphi rounds produced a final list of 20 EPAs, each differentiated as simple or complex, a defined entrustment scale, mapping of the EPAs to milestones, and graduation entrustment targets. A list of 159 procedural skills was similarly developed. Results of the faculty survey demonstrated favorable ratings on all questions regarding app usability as well as the utility of the app and EPA assessments. Over the 2-month pilot period, 1636 EPA and 1427 procedure assessments were submitted. All programs continued to use the app for the remainder of the academic year resulting in 12,641 submitted assessments.
Conclusions: A list of 20 anesthesiology EPAs and 159 procedural skills assessments were developed using a rigorous methodology to reach consensus among education experts. The assessments were pilot tested at 7 US anesthesiology residency programs demonstrating the feasibility of implementation using a mobile app and the ability to collect assessment data. Adoption at the pilot sites was variable; however, the use of the system was not mandatory for faculty or trainees at any site.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2021 International Anesthesia Research Society.)

Comment in: Anesth Analg. 2021 Jun 1;132(6):1576-1578. (PMID: 34032661)

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