Machelle Linsenmeyer 
Maryellen Gusic 

Background
Competency Based Medical Education (CBME) is being implemented around the world. A framework being used in CBME and assessment are Entrustable Professional Activities (EPAs). Both CBME and EPAs encompass processes and principles that are not always easy to operationalize. Anyone involved in such endeavors, be it in an administrative position, in a clinical department, or as an educational or assessment specialist interested in program development, will encounter moments that beg for consultancy. This workshop draws upon the multinational community to share and learn from peer wisdom and experiences. 

Why is the topic important for research and / or practice?
CBME and the use of EPAs can change depending on the purpose, context, mission, resources and culture of the organization. This means that processes, tools, implementations, and challenges can all be different.However, there are also many challenges that are likely to beshared as well.Therefore, it is important for all of us to have tools that can be used to easily self-reflect, problem-solve, and gain input from others. The torika method is such a tool. This method can be used to advance CBME and EPAs in practice. 

Workshop format, including participant engagement methods
 After a brief introduction (15 minutes) and the formulation of a pressing, CBME or EPA- related question that touches on the work of the participant in their local context (5 minutes), the group will be divided in trios of participants who are not from the same institution or program. Each trio will then engage in the ‘Troika Peer Consultation’ exercise (45 minutes). During this exercise, participants will pose their pressing question and receive consultation from others in the trio. The process will continue until all members of the group have vetted their question. At the end, all participants will come back together to close the session with a 25 minute plenary discussion with the workshop leaders, who are all experienced with CBME and EPAs. Detailed instructions for the Troika exercise will be shared during the workshop. The approach will also be adaptable to other situations where quick input or problem-solving is needed. 

Who should participate
Intended participants should have experience and background in working with CBME or EPAs. It would be helpful if they have participated in coursework or skills training related to CBME and/or EPAs, such as being alumni from the International Course Ins and Outs of EPAs. 

Level of the workshop
Intermediate 

Take-home messages/workshop outcomes/implications for further research or practice
Participants will share and gain fresh perspectives on the challenges of CBME and EPA development and implementation. Every participant will leave with peer advice for addressing the specific pressing question they posed to their peers. Acquaintance with the live Troika exercise procedure, as a faculty development tool, is also an outcome. 

References (maximum three) 

Trokia Consulting, Liberating Structures: Including and Unleashing Everyone. Accessed online 6/21/23: https://www.liberatingstructures.com/8-troika-consulting/ . 

Henri Lipmanowicz and Keith McCandless (2014) The Surprising Power of Liberating Structures: Simple Rules to Unleash A Culture of Innovation. 

Katrina Anderson^1,2
Brendan Crotty¹, Georga Cooke^1,3, Nicholas Glasgow^1,2, Jo Burnand^1,4 and Madeleine Novak¹
1 Australian Medical Council
2 Canberra Region Medical Education Council
3 Queensland Health
4 Health Education and Training institute NSW

Training for Australian Postgraduate Year (PGY) 1 and 2 doctors will undergo substantial changes under the new National Framework for Prevocational Medical Training commencing nationally in 2024. Changes to the prevocational outcomes, to the training environment and a strengthened assessment process will enhance and improve the prevocational doctors’ experience. As part of this new approach prevocational doctors will be assessed on four Entrustable Professional Activities (EPAs) that describe the essential work of PGY1 and PGY2 doctors. EPAs prioritise clinical experience as a critical part of prevocational training. Assessment of EPAs will increase structured opportunities for observation, feedback and learning and inform global judgements at the end of terms/years. 

This workshop is an opportunity for medical educators and those involved in clinical supervision to understand the concepts underpinning EPAs and how EPAs will contribute to the new prevocational framework. This workshop will explore the following key elements in relation to EPAs in the prevocational space: 

During this workshop we will introduce the EPAs and then use video examples to allow participants to explore the concepts, consider how EPA feedback conversations may unfold and generate discussion in small groups about implementation strengths and challenges. 

This workshop is for medical educators, clinical educators and supervisors, education leaders, and those involved in longitudinal workplace-based assessment. 

References (maximum three) 

Training and assessment requirements for prevocational (PGY1 and PGY2) training programs. Australian Medical Council Ltd. 2023: https://www.amc.org.au/framework/