EPAC: Education in Pediatrics Across the Continuum. Grand Rounds Betsy Murray, MD and Patty Hobday, MD February 26, 2014

Transcription

1 EPAC: Education in Pediatrics Across the Continuum Grand Rounds Betsy Murray, MD and Patty Hobday, MD February 26, 2014

2 Objectives 1. Understand the key elements of the Education in Pediatrics Across the Continuum (EPAC) educational pilot. 2. Understand the role of longitudinal integrated clerkships in medical student education. 3. Describe competency-based assessment for medical learners.

3 None. Disclosures

4 Introductions Patricia Hobday, MD, Course Director John Andrews, MD, Project Director Emily Borman-Shoap, MD, GME Director Betsy Murray, MD, UME Director Danielle Hans, Course Administrator

5 Goal Establish a time-variable model of medical education with meaningfullyassessed demonstration of competence and deliberate entrustment of responsibility across the UME-GME continuum.

6 Consortium Members University of California San Francisco University of Colorado University of Minnesota University of Utah

7 Partners Association of American Medical Colleges (AAMC) Accreditation Council for Graduate Medical Education (ACGME) American Board of Pediatrics (ABP)

8 Funding Josiah Macy, Jr. Foundation - $900,000 Dean s commitment to existing and in-kind support for at least 4 EPAC cohorts

9 Basic Project Elements Longitudinal Integrated Clerkship with a Pediatric Focus Competency-based assessment Seamless progression from undergraduate medical education (UME) to graduate medical education (GME)

10 Longitudinal Integrated Clerkships

11 EPAC: Local Context RPAP/MetroPAP UCAM VA-LIC

12 Longitudinal Integrated Clerkships: Basic Structure

13 Longitudinal Integrated Clerkships: Basic Structure Mon Tues Wed Thurs Fri Sat Sun ED Surgery Clinic Adol Gyn Clinic Selfdirected Gen Peds Clinic Medicine Clinic Selfdirected Selfdirected Family Medicine OB Inpatient night shift

14 Longitudinal Integrated Clerkships: Educational Continuity Patient care Curriculum Supervision

15 Longitudinal Integrated Clerkships: Current Knowledge Academic results are equivalent or better Improved patient communication Understanding of psychosocial issues More prepared for higher-order clinical skills More confidence in dealing with ethical problems

16 Competency-Based Assessment

17 Goal Establish a time-variable model of medical education with meaningfullyassessed demonstration of competence and deliberate entrustment of responsibility across the UME-GME continuum.

18 Competency-Based Assessment 2 main frameworks: 1. Competencies 2. Entrustable Professional Activities (EPAs)

19 Competencies example ACGME core competencies (6) e.g., Patient Care Is able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Gather essential and accurate information about their patients

20 Milestones Benchmarks on a developmental road map Pediatrics Milestone Project (2009)

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22 Entrustable Professional Activities (EPAs) Describe routine activities of a physician Focuses on level of supervision needed to carry that out

23 EPA example Core Entrustable Professional Activities for Entering Residency (CAPAER) Gather a history and perform a physical exam Enter and discuss patient orders/prescriptions

24 Back to EPAC Fits well into synergy of developed/developing competencies and EPAs across the medical education continuum

25 Conclusions 1. Understand the key elements of the Education in Pediatrics Across the Continuum (EPAC) educational pilot. 2. Understand the role of longitudinal integrated clerkships in medical student education. 3. Describe competency-based assessment for medical learners.

26 Questions/Discussion

27 References Hirsh DA, Ogur B, Thibault GE, Cox M. Continuity as an organizing principle for clinical education reform. N Engl J Med. 2007;356(8): Ogur B, Hirsh D, Krupat E, Bor D. The Harvard Medical School-Cambridge Integrated Clerkship: An Innovative Model of Clinical Education. Academic Medicine 2007;82(4): Hirsh D, Gaufberg G, Ogur B, Cohen P, Krupat E, Cox M, Bor D. Educational Outcomes of the Harvard Medical School- Cambridge Integrated Clerkship: A Way Forward for Medical Education. Acad Med. 2012;87(5):1-8. Walters L, Greenhill J, Richards J, Ward H, Campbell N, Ash J, Schuwirth L WT. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Medical Education 2012;46: O'Brien BC, Poncelet A, Hansen L, Hirsh D, Ogur B, Alexander E, Krupat E, Hauer KE. Students' workplace learning in two clerkship models: A multi-site observational study. Med Educ. 2012: 46: Hauer KE, Hirsh D, Ma I, Hansen L, Ogur B, Poncelet AN, Alexander EK, O'Brien BC. The role of role: learning in longitudinal integrated and traditional block clerkships. Med Educ. 2012;46: Ogur B, Hirsh D. Learning through longitudinal care narratives from the Harvard Medical School-Cambridge Integrated Clerkship. Acad Med. 2009;84: Irby DM. Educational Continuity in Clinical Clerkships. N Engl J Med. 2007;356(8): Core Entrustable Professional Activities for Entering Residency (CEPAER), Association of American Medical Colleges, Nov 2013, Draft ACGME Outcome Project General Competencies: ACGME Pediatric Milestones: Schumacher, et. al, The Pediatrics Milestones: Initial Evidence for Their use as Learning Road Maps for Residents. Acad Peds 2013 Jones, et al. Competencies, Outcomes, and Controversy Linking Professional Activities to Competencies to Improve Resident Education and Practice. Acad Med 2011 Nasca, et. al. The Next GME Accreditation System Rationale and Benefits. NEJM, March 2012.