Development of Breast Imaging Specific Entrustable Professional Activities Using a Double Delphi Technique

Multi-stakeholder validation of entrustable professional activities for a family medicine care of the elderly residency program: A focus group study

Entrustable Professional Activities (EPAs) have become widely used within Competency-Based Medical Education (CBME) for the training and evaluation of residents. Little is known about the effectiveness of incorporating multiple stakeholder groups in the validation of EPAs. Here, we seek to validate an EPA framework developed for the University of Manitoba Care of the Elderly Enhanced Skills program using online focus groups consisting of five stakeholder groups. Participants were recruited to take part in one of five online focus groups, one for each stakeholder group (physician faculty, residents, non-physician healthcare professionals, administrators/managers, and patients). Each group met one time for 90 minutes over ZOOM®. The themes arising from stakeholder feedback suggest that successful EPAs must neither be too specific nor too expansive in scope, clearly delineate appropriate means of evaluation, and indicate specific clinical settings in which each EPA should be evaluated. Cross-cutting themes included requiring trainees to collaborate with other professionals when it would optimize patient care, and preparing trainees to advocate for their patients' health (Advocacy). The present study demonstrates that multi-stakeholder analysis yields diverse feedback that can help make EPAs more clear, easier to use in evaluation, and more socially accountable.

Resident education in radiology in Europe including entrustable professional activities: results of an ESR survey

Entrustable professional activity (EPA) is a tool for comprehensively evaluating the level of confidence in resident performances across various competencies in medicine. The application of and attitudes towards EPAs in radiology across the European Society of Radiology (ESR) national institutional member societies is still to be determined. An online survey was conducted among ESR national institutional member societies to assess the current use of EPAs and other resident assessment forms among different countries.Although the primary focus was on the use of EPAs, additional questions also addressed the adherence of training programs to the European Training Curriculum (ETC), other methods of continuous assessment, and examinations. A total of 65 responses were received from 38 countries (81% response rate among national institutional member societies). EPAs were being used in radiology in 21% of countries and planned to be used in 26%. Most responders considered EPAs suitable for radiology and, regarding the future, preferred European-level guidelines on EPAs over national or institutional levels. The majority (63%) of national training programs were reported to be similar to or following the content of the ETC, and the majority (95%) of countries rated the requirements of the European Training Curriculum (ETC) to be adequate. In conclusion, EPAs are beginning to be used in radiology resident training programs across Europe, and their use is expected to increase. There seems to be a positive attitude toward using EPAs in radiology and toward a common European framework.Critical relevance statement As a result of this survey, we found positive attitudes towards using entrustable professional activities (EPA) in radiology among the institutional member societies of the European Society of Radiology (ESR).Key points• Twenty-one percent of national member societies use entrustable professional activities (EPA) in radiology.• There is a positive attitude toward using EPAs in radiology.• Majority of respondents preferred a common European framework for EPAs.• Majority of radiology training curricula adhere to the European Training Curriculum (ETC).

Responsive Web-based Breast Imaging Core Curriculum for International Radiology Residents with Self-Assessment: A Pilot Study

RATIONALE AND OBJECTIVES

Lack of uniformity in radiology resident education is partially attributable to variable access to subspecialty education. Web-based courses improve standardization, but with growing emphasis on competency based education, more evaluation of their effectiveness is needed. We created a responsive web-based breast imaging curriculum for radiology residents including self-assessment and a satisfaction survey.

MATERIALS AND METHODS

Two global academic institutions collaboratively developed a breast imaging curriculum to address radiology residents' educational needs. This virtual course comprised 11 video lectures, nine didactic (with attached pre-test and post-test assessments) and two case review sessions. In April 2020, this optional curriculum was made available to all 56 radiology residents in one residency program cluster in Singapore, to be accessed alongside the breast imaging rotation as a supplement. A voluntary anonymous satisfaction survey was provided upon completion.

RESULTS

A total of 39 of the 56 radiology residents (70%) completed the course. For the average score of nine lectures (maximum score 5), there was a significant increase in mean pre and post - test scores (mean = 2.2, SD = 0.7), p < 0.001. The proportion of residents with improvement between the pre-test score and the post-test score ranged from 74% to 100% (mean, 84%). Thirty three of the 39 participants (85%) completed the satisfaction survey, and all agreed or strongly agreed that the curriculum increased their knowledge of breast imaging.

CONCLUSION

This web based breast imaging curriculum supplement was viewed positively by participating residents and improved their self-assessed knowledge. Curriculum access could be expanded to improve global radiology education.

ACGME Diagnostic Radiology Milestones 2.0: the Time is Now

The Accreditation Council for Graduate Medical Education oversees graduate medical education in the United States. Designed to provide broad based training in all aspects of imaging, the diagnostic radiology residency program must provide educational experiences that not only provide technical, professional, and patient centered training, but also meet accreditation standards. With the breadth of material to cover during training, carefully orchestrated educational experiences must be planned. This manuscript offers residency program leaders resources to meet the challenges of the new Accreditation Council for Graduate Medical Education Diagnostic Radiology Milestones 2.0 and highlights potential opportunities for future educational endeavors.

Developing Entrustable Professional Activities for the Training of Translational Scientists: A Modified Delphi Study

PURPOSE

Improved training for translational scientists is important to help address the waste of resources and irreproducibility of research outcomes in current translational medicine. However, there are a lack of training programs that cover the full range of knowledge and skills translational scientists need to develop, and many translational research training programs struggle to develop competency frameworks and assessment tools. Entrustable professional activities (EPAs) have been successfully implemented to link competencies with everyday practice in training health care professionals but have not yet been developed for research training. The purpose of the current study was to develop EPAs for translational scientists that could be used for their training and assessment and help increase the transparency and reproducibility of research outcomes and methods by providing best practices for translational research.

METHOD

In 2019, a modified Delphi technique, preceded by a focus group held in 2018 using a nominal group technique, was used to reach consensus on EPA titles and content among an international panel of 22 translational experts. Mean, standard deviation, and level of agreement were calculated after each round. Consensus was defined as ≥ 80% agreement.

RESULTS

Consensus was reached on 89% of the items after the first round and 100% after the second round. The final list of EPAs consists of 17 EPAs divided over 7 sections.

CONCLUSIONS

The concept of EPAs is new to the field of research training. The 17 EPA titles and their descriptions developed in this study may be used as a framework for improved training for translational scientists with the ultimate goal to contribute to closing the gap between bench and bedside, reducing resource waste in science, and increasing the reproducibility of research outcomes.