Genetic Counseling Milestones: A Framework for Student Competency Evaluation

Proposed use of entrustable professional activities (EPAs) in genetic counseling for clinical training and assessment

We introduce Entrustable Professional Activities (EPAs) as a potential framework for clinical training and assessment in genetic counseling. We discuss advantages of this approach, review how EPAs complement Practice-Based Competencies (PBCs), describe our process of generating proposed "core" EPAs, provide examples of specialty-specific EPAs, discuss the concept of entrustment in clinical training, and propose an approach to implementation.

Lessons from the implementation of developmental progress assessment: A scoping review

OBJECTIVES

Educators and researchers recently implemented developmental progress assessment (DPA) in the context of competency-based education. To reap its anticipated benefits, much still remains to be understood about its implementation. In this study, we aimed to determine the nature and extent of the current evidence on DPA, in an effort to broaden our understanding of the major goals and intended outcomes of DPA as well as the lessons learned from how it has been executed in, or applied across, educational contexts.

METHODS

We conducted a scoping study based on the methodology of Arksey and O'Malley. Our search strategy yielded 2494 articles. These articles were screened for inclusion and exclusion (90% agreement), and numerical and qualitative data were extracted from 56 articles based on a pre-defined set of charting categories. The thematic analysis of the qualitative data was completed with iterative consultations and discussions until consensus was achieved for the interpretation of the results.

RESULTS

Tools used to document DPA include scales, milestones and portfolios. Performances were observed in clinical or standardised contexts. We identified seven major themes in our qualitative thematic analysis: (a) underlying aims of DPA; (b) sources of information; (c) barriers; (d) contextual factors that can act as barriers or facilitators to the implementation of DPA; (e) facilitators; (f) observed outcomes, and (g) documented validity evidences.

CONCLUSIONS

Developmental progress assessment seems to fill a need in the training of future competent health professionals. However, moving forward with a widespread implementation of DPA, factors such as lack of access to user-friendly technology and time to observe performance may render its operationalisation burdensome in the context of competency-based medical education.

Milestones for medical students completing a clinical genetics elective

PURPOSE

We are not aware of any competency-based evaluation method that is specifically designed for a genetics elective for medical students. Here, we aimed to create a milestone template to improve evaluation and to use the feedback from the template to improve the elective.

METHODS

Through an iterative process using feedback from eight medical students and eight attendings, we crafted a milestone template for the medical student genetics rotation. A "scavenger hunt" of activities was developed to address several gaps discovered through this process.

RESULTS

All participants felt that the milestone template was complete for the student level and that it improved evaluation. In response to faculty feedback, we modified the evaluation process such that several evaluators rated students in only selected domains. Scavenger hunt activities were designed to address five domains that the students reported to be inadequately covered.

CONCLUSION

Developing a milestone template has taken us a step closer to meaningful assessment of students completing the genetics elective and simultaneously allowed us to strengthen the elective. Meaningful elective experiences in genetics that provide individual feedback within a learner-centered assessment of progress and flexible out-of-classroom activities may contribute to lifelong learning and interest in genetics and genomics.Genet Med 19 2, 236-239.