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Content Background

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Goals of the Core EPAs Pilot

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Primary Goal: To demonstrate the feasibility of implementing the Core EPAs for Entering Residency framework in the path to graduation of M.D. candidates.

Specifically, we hope to answer questions in four main areas:

1. Curriculum development:

  • How do we teach students the knowledge, skills, and attitudes needed for each of the EPAs?
  • What do we teach students in order for them to be able to independently perform the skills needed for each EPA?
  • When do we teach each of these skills?
  • In what order do we teach each skill?
  • What components are best taught in a classroom? In a small group? In a simulated environment? In a clinical setting?

2. Assessment of competency using the EPA framework:

  • How many observations are needed for each of the EPAs?
  • What contexts (e.g., children versus adult, acute versus ambulatory setting, simple versus complex disease) are essential to observe for each EPA?
  • How consistent must the performance of the students be to be entrusted to perform the activity without direct supervision?
  • Are they assessed as a bundle or does the assessment of each component add up to a complete EPA assessment?

3. The path to entrustment:

  • Who makes the entrustment decision?
  • When is the decision made?
  • How is the decision documented?
  • How and when is developmental information about entrustment conveyed to residency program directors?
  • How do residency program directors view the credibility of entrustment decisions?

4. Faculty development:

  • How do we teach faculty about CBME and EPAs? Can this be scaled (webinar or online? Small group?)
  • What are the faculty development needs for helping faculty to assess competence through this EPA framework?
  • How do we reach community based faculty?
  • What data do we need to track faculty assessment decisions?
  • What forms, videos, and other learning materials need to be produced?

Secondary goal: To demonstrate improvement in the gap between performance and expectations for students entering residency who have been entrusted on the Core EPAs.

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