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Social constructivist learning design principles in post-professional clinical skill assessments: embedding a Shared Decision Making (SDM) entrustable professional activity (EPA)

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Oral Presentation

4:00 pm

27 February 2024

M210

EPAs: Theoretical aspects

Presentation Description

Sonya Moore1
Alex Tsirgialos1, Elise Fraser1 and Selina Parry1
 1 University of Melbourne 



Background 
Post-professional clinical education aims to advance integration of granular skills within complex clinical encounters. This aligns with social constructivist learning models and entrustable professional activities (EPAs) which frame constituent skills and end-performance of more complex tasks [1]. 


Summary of work 
Our scoping review [2] identified the Shared Decision Making (SDM) EPA [3] as well aligned to the skills needed in post-professional physiotherapy and podiatry practice. Social constructivist learning principles were used to embed SDM within a variety of clinical learning activities and video assessments. Learners explored the SDM EPA; used discussion boards to deconstruct expert clinician video demonstrations; and peer reviewed their own-practice skill integration. Ethics approval (Melbourne University, ref:2023-23744-42190-1) was obtained to evaluate subject assessment performance outcomes and student experience. 


Results 
Students completing the subject (n=10) demonstrated SDM capability within clinical video assessments. Of the subject evaluation student survey participants (n=4), all agree tutorial discussion boards improved assessment preparation. Most agreed (n=3) or neutral (n=1) this approach improved assessment preparation. Qualitatively, students valued tutor engagement, timely instructional guidance and constructive feedback. 


Discussion 
EPAs, such as SDM, are designed to capture performance of clinical skills in real-world settings. Good learning design can scaffold post-professional clinicians' capability to perform EPAs consistently, with a balance of automaticity and decision making. This includes organizing, integrating, co-ordinating and executing a repertoire of clinical skills in real-world encounters. Video capture with self and peer review of SDM practice enabled further skill refinement, including exposure to different interprofessional application contexts. Future evaluation with larger student numbers will extend upon initial insights. 

Conclusions 
Using learning design to embed the SDM EPA in clinical video assessments captured meaningful task organization for practicing clinicians. 


Take-home messages 
Clinical video assessments can have:
 • Grounding in learning design models
 • Embedded post-professional EPAs, for example SDM • Expert clinician-tutor facilitation 




References (maximum three) 

[1] van Merriënboer, J. (2021). The Four-Component Instructional Design Model An Overview of its Main Design Principles. Accessed 1/8/2023 at: https://www.4cid.org/wp- content/uploads/2021/04/vanmerrienboer-4cid-overview-of-main-design-principles-2021.pdf 

[2] Moore SJ, Egerton T, Merolli M, Lees J, La Scala N, Parry SM. Inconsistently reporting post-licensure EPA specifications in different clinical professions hampers fidelity and practice translation: a scoping review. BMC Med Educ. 2023 May 24;23(1):372. doi: 10.1186/s12909- 023-04364-4. PMID: 37226147; PMCID: PMC10207741. 

[3] Baghus A, Giroldi E, Muris J, Stiggelbout A, van de Pol M, Timmerman A, van der Weijden T. Identifying Entrustable Professional Activities for Shared Decision Making in Postgraduate Medical Education: A National Delphi Study. Acad Med. 2021 Jan 1;96(1):126-133. doi: 10.1097/ACM.0000000000003618. PMID: 32739926; PMCID: PMC7769188. 

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