Presentation Description
Tzu-Hung Liu1
1 Taipei Tzu Chi Hospital
1 Taipei Tzu Chi Hospital
Background
For postgraduate trainees, the individualized learning plan (ILP) program is one of the potential measures that facilitate self-directed learning.[1] The learning goals in ILP can be translated into entrustable professional activities (EPAs). Entrustment‐based discussion (EBD) with a set of four questions has been proposed as an assessment tool for EPAs.[2] Therefore, we aim to use EBD in ILP for PGY-1 trainees in our study.
Summary of work
We developed ILP programs for PGY-1 trainees in their 3-month internal medicine rotations, including monthly mentoring meetings. In the first meeting, the trainees generate two learning goals in the form of EPAs with their clinical mentor. In the following meetings, the mentor would use the four questions in EBD to ask the trainees and determine their entrustment level using the Chen entrustment scale.[3]
Results
From August 2022 to July 2023, 18 PGY-1 trainees participated in this study. Their 36 EPAs aligned mainly with two ACGME competencies, patient care and medical knowledge. According to the EBD results, most trainees’ entrustment levels were level 3b (with supervisor immediately available; key findings double-checked) (47.2%) or 3c (with supervisor distantly available; findings reviewed) (30.6%) at the end of the program.
Discussion
Trainees with level 3c entrustment in their EPAs could answer all four questions well in EBD. However, trainees with level 3b entrustment in their EPAs answered varying numbers of questions in EBD correctly. For common EPAs, correctly answering the first three questions is adequate for level 3b; for difficult EPAs, answering all four questions well does not guarantee a level 3c.
Conclusions
Trainees who answered more questions correctly in EBD tend to have higher entrustment levels. The entrustment level may be lower for more difficult EPAs.
Take-home messages
EBD can be a useful assessment tool in ILP to generate entrustment levels for the PGY-1 trainees.
References (maximum three)
- Li STT, Burke AE. Individualized learning plans: basics and beyond. Acad Pediatr. 2010;10(5):289–292.
- ten Cate O, Hoff RG. From case‐based to entrustment‐based discussions. Clin Teach. 2017;14(6):385-389.
- Chen HC, van den Broek WS, ten Cate O. The case for use of entrustable professional activities in undergraduate medical education. Acad Med. 2015;90(4):431-436.