1
|
Fu CP, Huang CK, Yang YC, Liao WS, Huang SM, Chang WD, Chen YJ, Li MW, Lin YJ, Wu CL, Chi HY, Lee CY, Chiang FM, Chen YL, Tsou CF, Liu TH, Su CT, Yang AL, Kuo NC, Chang WY. Developing an entrustable professional activity for providing health education and consultation in occupational therapy and examining its validity. BMC MEDICAL EDUCATION 2024; 24:705. [PMID: 38943116 PMCID: PMC11214254 DOI: 10.1186/s12909-024-05670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/18/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. METHODS Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. RESULTS The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. CONCLUSION The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings.
Collapse
Affiliation(s)
- Chung-Pei Fu
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ching-Kai Huang
- Department of Rehabilitation, Occupational Therapy, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chiun Yang
- Department of Rehabilitation, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Wei-Sheng Liao
- Department of Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shih-Min Huang
- Department of Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Wei-Di Chang
- Department of Rehabilitation, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yi-Ju Chen
- Department of Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Wei Li
- Department of Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Yi-Ju Lin
- Department of Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Chin-Lung Wu
- Department of Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsin-Yu Chi
- Department of Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Chia-Yi Lee
- Department of Rehabilitation, Cathay General Hospital, Taipei, Taiwan
| | - Fu-Mei Chiang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Lan Chen
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Fen Tsou
- Department of Rehabilitation, Cathay General Hospital, Taipei, Taiwan
| | - Tzu-Hung Liu
- Department of Family Medicine, Taipei Tzu Chi Hospital, New Taipei City, Taiwan
- School of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Chia-Ting Su
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ai-Lun Yang
- Institute of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Nung-Chen Kuo
- Department of Occupational Therapy, Taoyuan General Hospital, Ministry of Health and Welfare,, No. 1492, Zhongshan Rd.,Taoyuan Dist., Taoyuan, 330, Taiwan.
| | - Wan-Ying Chang
- Department of Physical Medicine and Rehabilitation, Taipei Hospital, Ministry of Health and Welfare, No. 127, Su-Yuan Rd., Hsin-Chung Dist., New Taipei City, Taiwan.
| |
Collapse
|
2
|
Varghese CJ, Mueller A, Schafer L, Ebisu R, Dao V, Njau E. Pharmacist Interventions in a Palliative PLUS Program at a Veterans Affairs Medical Center. J Palliat Med 2024; 27:784-788. [PMID: 38466991 DOI: 10.1089/jpm.2023.0552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Background: Palliative PLUS (PP) at the Minneapolis Veterans Affairs Health Care System (MVAHCS) is an interdisciplinary team that seeks to improve veteran access to palliative and hospice resources. Palliative care pharmacists were incorporated to increase patient access to palliative specialties. Objective: To identify and categorize pharmacist interventions within an outpatient PP team at the MVAHCS. Methods: This quality improvement project was a retrospective analysis of the electronic health record. Results: A total of 84 patients were participating in the PP program over 13 months. Among those patients, 25 had pharmacist involvement and a total of 56 interventions were identified. Of those interventions, 29 (51.8%) were direct interventions and 27 (48.2%) were curbside consults. Most interventions involved medication counseling and medication adherence. Conclusion: Pharmacists made an impact on the PP team through direct patient interventions involving medication counseling and aided the interdisciplinary team by facilitating patient medication adherence.
Collapse
Affiliation(s)
| | - Amanda Mueller
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Lara Schafer
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Reika Ebisu
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Vinh Dao
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Esther Njau
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| |
Collapse
|
3
|
Tu CY, Huang KM, Cheng CH, Lin WJ, Liu CH, Yang CW. Development, implementation, and evaluation of entrustable professional activities (EPAs) for medical radiation technologists in Taiwan: a nationwide experience. BMC MEDICAL EDUCATION 2024; 24:95. [PMID: 38287396 PMCID: PMC10826224 DOI: 10.1186/s12909-024-05088-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Competency-based medical education (CBME) is an outcomes-oriented approach focused on developing competencies that translate into clinical practice. Entrustable professional activities (EPAs) bridge competency assessment and clinical performance by delineating essential day-to-day activities that can be entrusted to trainees. EPAs have been widely adopted internationally, but not yet implemented for medical radiation professionals in Taiwan. MATERIALS AND METHODS A nationwide consensus process engaged 97 experts in radiation technology education representing diagnostic radiography, radiation therapy, and nuclear medicine. Preliminary EPAs were developed through the focus group discussion and the modified Delphi method. The validity of these EPAs was evaluated using the QUEPA and EQual tools. RESULTS Through iterative consensus building, six core EPAs with 18 component observable practice activities (OPAs) in total were developed, encompassing routines specific to each radiation technology specialty. QUEPA and EQual questionnaire data verified these EPAs were valid, and of high quality for clinical teaching and evaluation. CONCLUSION The consensus development of tailored EPAs enables rigorous competency assessment during medical radiation technology education in Taiwan. Further expansion of EPAs and training of clinical staff could potentially enhance care quality by producing competent professionals.
Collapse
Affiliation(s)
- Chun-Yuan Tu
- Taiwan Association of Medical Radiation Technologists, Taipei, Taiwan
- Department of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan
| | - Kuo-Ming Huang
- Taiwan Association of Medical Radiation Technologists, Taipei, Taiwan
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hsueh Cheng
- Taiwan Association of Medical Radiation Technologists, Taipei, Taiwan
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Jou Lin
- Taiwan Association of Medical Radiation Technologists, Taipei, Taiwan
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Heng Liu
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei, 100, Taiwan
| | - Chih-Wei Yang
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
| |
Collapse
|
4
|
Lowry MF, Lockman K, Herndon C, Atayee RS, Juba KM, Pawasauskas J, Phantumvanit V, Ray JB, Pruskowski J. Development and validation of a performance-based palliative care assessment tool for student pharmacists. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:39-48. [PMID: 38158329 DOI: 10.1016/j.cptl.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/28/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Integration of hospice and palliative care principles within pharmacy curricula is essential to fill the need of pharmacist training in this growing specialty. A formalized assessment tool to evaluate skill development does not exist for student pharmacists specific to palliative care. The objective of this study was to develop a valid and reliable, palliative care-focused, performance-based assessment tool for student pharmacists. METHODS Eight academic palliative care (PC) pharmacists were recruited for the workgroup to perform domain development, validation, tool creation, and reliability testing for this performance-based assessment tool. Hospice and palliative care clinical pharmacist entrustable professional activities (EPAs) served as the framework. Content validity testing utilized content validity index and scale universal agreement (S-CVI/UA) to determine level of agreement for activities included in the tool. Student volunteers completed a standardized patient case and workgroup members served as raters during the reliability testing phase. Interrater reliability was measured through calculation of Fleiss Kappa scores for each activity. RESULTS Out of 14 EPAs, nine were deemed "essential" to include in the tool. Thirty-four supporting activities for the nine essential EPAs were drafted. Two rounds of content validity testing were necessary to achieve S-CVI/UA of 0.9593. Consensus was reached from workgroup members for activities deemed necessary to include in the tool after questionnaire distribution utilizing a Fleiss Kappa cutoff >0.6. CONCLUSIONS This validated tool will afford colleges and schools of pharmacy with PC curricula an opportunity to assess student achievement of PC-specific skills and evaluate curricular effectiveness.
Collapse
Affiliation(s)
- Maria Felton Lowry
- University of Pittsburgh School of Pharmacy, Department of Pharmacy and Therapeutics, 3501 Terrace Street, Pittsburgh, PA 15213, United States; UPMC Palliative and Supportive Institute, Iroquois Building, Suite 308.15, 3600 Forbes Avenue at Meyran Ave, Pittsburgh, PA 15213, United States.
| | - Kashelle Lockman
- University of Iowa College of Pharmacy, 180 S Grand Ave, 336 CPB, Iowa City, IA 52242, United States.
| | - Christopher Herndon
- Southern Illinois University Edwardsville, 200 University Park Drive, Edwardsville, IL 62026, United States
| | - Rabia S Atayee
- University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego Health, Palliative Care Program, 9255 Pharmacy Lane, MC 0657, La Jolla, CA 92093, United States.
| | - Katherine M Juba
- St. John Fisher University, Wegmans School of Pharmacy, 3690 East Ave., Rochester, NY 15618, United States.
| | - Jayne Pawasauskas
- University of Rhode Island College of Pharmacy, 7 Greenhouse Rd, 295A Avedisian Hall, Kingston, RI 02881, United States.
| | - Victor Phantumvanit
- Clinical Pharmacy Specialist, Palliative Care, Dana-Faber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, United States.
| | - James B Ray
- University of Iowa College of Pharmacy, 180 S Grand Ave, 336 CPB, Iowa City, IA 52242, United States.
| | - Jennifer Pruskowski
- University of Pittsburgh School of Pharmacy, Department of Pharmacy and Therapeutics, 3501 Terrace Street, Pittsburgh, PA 15213, United States; Pittsburgh Geriatric Research Education and Clinical Center (GRECC), Pittsburgh Veterans Affairs, Healthcare System, Pittsburgh, PA, United States; University of Pittsburgh School of Medicine, Division of Geriatric Medicine, Kaufmann Medical Building, Suite 500, 3471 Fifth Avenue, Pittsburgh, PA 15213, United States.
| |
Collapse
|
5
|
Atayee RS, Edmonds KP. A Specialist Palliative Pharmacist Enriches the Interdisciplinary Team: A Case Series Discussion Illustrating the Entrustable Professional Activities for Specialist Hospice and Palliative Care Pharmacists. J Palliat Med 2023; 26:1755-1758. [PMID: 37358818 DOI: 10.1089/jpm.2023.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Introduction: Palliative care (PC) pharmacists are an integral member of the PC team. Essential roles have been defined and entrustable professional activities (EPAs) have been recently developed for hospice and PC pharmacists. Case Description: We review four different complex patient cases where the specialist PC pharmacist worked with the interdisciplinary team to address whole patient suffering. Through the case series, we highlight the various components of HAPC pharmacist EPAs across the continuum of care. Case Management, Outcome, and Conclusion: Through the case series discussion, we brought to light PC pharmacists' EPAs in pharmacotherapy consultation, assessing and optimizing medication therapy, symptom management, deprescribing, participating in goals-of-care discussions, managing medication therapy in the withdrawal of life-sustaining therapy in collaboration with interdisciplinary team in alignment with patient and family values, prognosis, and plan of care. We also emphasized the importance of PC pharmacists contributing to the advancement of science.
Collapse
Affiliation(s)
- Rabia S Atayee
- Palliative Care Program, University of California, San Diego, San Diego, California, USA
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, UC San Diego Section of Palliative Care, La Jolla, California, USA
- San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, La Jolla, California, USA
- Department of Pharmacy, University of California Health, La Jolla, California, USA
| | - Kyle P Edmonds
- Palliative Care Program, University of California, San Diego, San Diego, California, USA
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, UC San Diego Section of Palliative Care, La Jolla, California, USA
| |
Collapse
|
6
|
Dahlin C. Interprofessional Specialty Palliative Care Education and Training. CURRENT GERIATRICS REPORTS 2023. [DOI: 10.1007/s13670-023-00381-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
|
7
|
Bacon M, Kematick B, Suliman I, Scullion B, Chua I, Given S, Lally K. Development of PharmPAL: A Collaborative Practice Pharmacy Clinic in Ambulatory Palliative Care. Am J Hosp Palliat Care 2022; 40:475-479. [PMID: 36052826 DOI: 10.1177/10499091221120593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Increased access to interprofessional palliative care is needed in ambulatory oncology settings. To achieve this, Dana-Farber Cancer Institute launched a collaborative drug therapy management clinic, PharmPAL, where credentialed advanced practice pharmacists lead independent patient visits. METHODS As part of a pilot project focused on clinical innovation, we analyzed PharmPAL referrals and pharmacist interventions between July 2020 and June 2021. We extracted referral patterns, patient hospitalizations, and deaths from the electronic medical record. Outpatient palliative care clinicians completed a survey to determine pharmacist needs and overall satisfaction with PharmPAL. RESULTS From July 2020 to June 2021, PharmPAL constituted 4.7% (299/6305) of all outpatient palliative care encounters. Most palliative care clinicians (86% [6/7]) reported a desire to increase PharmPAL availability. No patient hospitalizations or deaths were attributed to PharmPAL visits. CONCLUSION PharmPAL increased access to palliative care services. All clinicians reported satisfaction with PharmPAL. We continue to assess the impact PharmPAL has on clinic operations and provider satisfaction.
Collapse
Affiliation(s)
- Molly Bacon
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA
| | - Benjamin Kematick
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA
| | - Iman Suliman
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bridget Scullion
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA
| | - Isaac Chua
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA.,Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sarah Given
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kate Lally
- Department of Psychosocial Oncology and Palliative Care, 1855Dana-Farber Cancer Institute, Boston, MA, USA.,Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|