development of entrustable professional activities (epas) for public health and preventive medicine...
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Development of Entrustable Professional Activities (EPAs) for Public Health and Preventive Medicine
(PHPM)
PHPC CPD Event - May 24, 2015
Kieran Moore MD, CCFP(EM), FCFP, MPH, DTM&H, FRCPCProgram Director, Queen’s University
Brent Moloughney, MD, MSc, FRCPCPublic Health Consultant
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Conflict of Interest Disclaimer
No relationship with commercial entities such as:
Pharmaceutical organization Medical device company Communications firm
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Acknowledgements
• PHPM Program Directors across Canada• Participants at Queen’s Workshop (March
2015)
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Overview
• What are EPAs?• Why EPAs?• Approach to development• Current status• Next steps
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Entrustable Professional Activities (EPAs)
• Capture the work that is central/critical to a specialty - in aggregate, represent the essential professional work that defines a discipline.
• Link competencies/milestones to practice in an integrated/holistic manner
• Be more explicit about assessing and documenting performance of specific activities/tasks
• Support graded supervision – entrust the activity to a trainee to execute once obtained adequate competence
• Being pursued by multiple disciplines around the world
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CBME• Increasing shift to competency-based medical
education (CBME)– Explicit competencies to be acquired – Stages of competence development defined by
achievement of competency-based milestones– More frequent, direct observation to evaluate
• Detailed lists of competencies to be acquired (Objectives of Training)– Provide clarity of what is expected– But,
• Potentially overwhelming for residents and faculty• Competence requires integration of competencies
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Objectives of Training – Analytic Approach
ten Cate. ICRE 2013
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EPAs - Synthetic Approach
ten Cate. ICRE 2013
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Royal CollegeCanMEDS 2015
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Royal College: EPAs and Milestones• RC intends to use milestones and EPAs to redesign
specialist training and assessment– Milestone is observable marker of an individual's ability
along a developmental continuum– EPA is the task that must be accomplished - each EPA
integrates multiple milestones• Vision for application:– Use milestones to design educational activities and teach
specific abilities, skills and attitudes– Assess overall achievement of various milestones using
an EPA http://www.royalcollege.ca/portal/page/portal/rc/resources/publications/dialogue/vol15_2/epa_milestones
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EPAs are the tasks that must be accomplished, whereas milestones are the abilities of the individual
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Example*• EPA: Manage an infectious disease outbreak• Milestones (examples)– Transition to discipline (post-MD clinical)
• Elicit relevant information for a suspect reportable disease
– Foundations (coursework)• Describe steps in an outbreak investigation
– Core (early rotations)• Assume under direct supervision a support role (e.g., case
finding plan; generate case definition; etc.)
– Transition to practice (late rotation)• Assume under minimal supervision the lead role (e.g.,
declare outbreak; organize team; plan/implement investigation; etc.)*Calgary EPA Curriculum
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Initiative Goal
• Establish a national core set of PHPM EPAs with corresponding milestones that are supported by case-based learning scenarios and simulations.
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Path to PHPM EPAs
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PHPM EPAs – draft v1
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‘Optional’ EPAs
• Diversity of PHPM practice that extends beyond formal government-mandated public health institutions
• These career paths while mentioned in introduction to Objectives of Training, not directly addressed in the competencies or core EPAs
• Strong interest expressed by Program Directors to develop one or more optional EPAs, e.g.,– PHPM-oriented clinical practice– Broader health system leadership/stewardship
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Next Steps
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Further Information
• PHPM EPA development resources: http://familymedicine.queensu.ca/education/phpm/competency_by_design_initiative/resources
• Kieran Moore: [email protected]
• Brent Moloughney: [email protected]