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Ahn E, LaDonna KA, Landreville JM, Mcheimech R, Cheung WJ. Only as Strong as the Weakest Link: Resident Perspectives on Entrustable Professional Activities and Their Impact on Learning. J Grad Med Educ 2023; 15:676-684. [PMID: 38045932 PMCID: PMC10686661 DOI: 10.4300/jgme-d-23-00204.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/20/2023] [Accepted: 08/20/2023] [Indexed: 12/05/2023] Open
Abstract
Background Core to competency-based medical education (CBME) is the use of frequent low-stakes workplace-based assessments. In the Canadian context, these observations of performance are framed around entrustable professional activities (EPAs). Objective We aimed to explore residents' real-world perspectives of EPAs and their perceived impact on learning, because assessments perceived to be "inauthentic," or not truly reflective of their lived experiences, may interfere with learning. Methods Using constructivist grounded theory, we conducted 18 semistructured interviews in 2021 with residents from all programs that had implemented CBME at one tertiary care academic center in Canada. Participants were recruited via email through respective program administrators. Data collection and analysis occurred iteratively, and categories were identified using constant comparative analysis. Results Residents were strikingly polarized, perceiving EPAs as either a valuable opportunity for professional growth or as an onerous requirement that interfered with learning. Regardless of what view participants held, all perspectives were informed by: (1) the program administration and the perceived messaging from program to residents; (2) faculty assessors and their perceived degree of engagement, or "buy-in" with the EPA system; and ultimately (3) learner behavior. We theorized from these findings that all 3 aspects must be working in tandem for the assessment system to function as intended. Conclusions From the learners' perspective, there exists a dynamic, interdependent relationship between the 3 CBME stakeholders. As such, the perceived value of the EPA assessment system can only be as strong as the weakest link in the chain.
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Affiliation(s)
- Eusang Ahn
- Eusang Ahn, MD, MS (MedEd), Dipl. KSEM, FRCPC, is Clinician Fellow, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kori A. LaDonna
- Kori A. LaDonna, PhD, is Associate Professor, Department of Innovation in Medical Education and Department of Medicine, Lead, Qualitative Education Research, and Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey M. Landreville
- Jeffrey M. Landreville, MD, MMed, FRCPC, is Program Director and Assistant Professor, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Rawad Mcheimech
- Rawad Mcheimech, BA, is Research Coordinator, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada; and
| | - Warren J. Cheung
- Warren J. Cheung, MD, MMEd, FRCPC, DRCPSC, is Associate Director of Education Innovation, Director of Assessment, and Associate Professor, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Tung EL, Awan OA. Becoming an Expert Radiology Educator Through Deliberate Practice. Acad Radiol 2023; 30:3150-3152. [PMID: 36283912 DOI: 10.1016/j.acra.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Eric L Tung
- Diagnostic Radiology Resident (E.L.T.), Massachusetts General Hospital, Boston, MA
| | - Omer A Awan
- University of Maryland School of Medicine (O.A.A.), 655 W Baltimore Street, Baltimore, MD 21201.
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