Abstract
Objective
Within 10 years, the Association of American Medical Colleges envisions graduating medical students will be entrusted by their school to perform 13 core entrustable professional activities (EPAs) without direct supervision. The authors focused on eight EPAs that appear most relevant to clinical training during the psychiatry clerkship at their institution to evaluate whether students assess themselves as making progress in EPAs during this clerkship, to see how students’ self-assessments compare with the clerkship director’s assessments, and to see if weaknesses in the curriculum were found.
Methods
An EPA-assessment scale was designed (ratings 1 to 5) to assess progress toward entrustment in each EPA. Medical students completed pre- and post-psychiatry clerkship self-assessments. The clerkship director independently assessed each student’s progress in EPAs utilizing assessment methods already present in the curriculum.
Results
Seventy of 116 students (60.3%) completed both pre- and post-clerkship self-assessments. These ratings increased significantly from pre- to post-clerkship, representing large effect sizes from 0.83 to 1.13. The largest mean rating increase was observed for EPA 2, Prioritize a differential diagnosis following a clinical encounter. Mean post-clerkship self-assessment ratings were significantly higher than mean post-clerkship instructor ratings for seven of the eight EPAs.
Conclusions
The results suggest training during the psychiatry clerkship can contribute to the professional development of medical students in the eight EPAs studied but that student self-assessments tend to be higher than those of the clerkship director. Further study is needed of the relative value and role of student self-assessments versus faculty assessments of progress in EPAs.
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References
Dhaliwal U, Gupta P, Singh T. Entrustable professional activities: teaching and assessing clinical competence. Indian Pediatr. 2015;52:591–7.
Chen HC, McNamara M, Teherani A, ten Cate O, O’Sullivan P. Developing entrustable professional activities for entry into clerkship. Acad Med. 2016;91:247–55.
Association of American Medical Colleges. Core Entrustable Professional Activities for Entering Residency, Curriculum Developer’s Guide, 2014.
Chen H, van den Broek S, ten Cate O. The case for use of entrustable professional activities in undergraduate medical education. Acad Med. 2015;90:431–6.
Englander R, Carraccio C. From theory to practice: making entrustable professional activities come to life in the context of milestones. Acad Med. 2014;89:1321–3.
Aylward M, Nixon J, Gladding S. An entrustable professional activity (EPA) for handoffs as a model for EPA assessment development. Acad Med. 2014;89:1335–40.
Klapheke M, Johnson TR, Cubero M. Assessment of entrustable professional activities (EPAs) during the third and fourth years of medical school, including pre- and post-psychiatry clerkship. MedEdPORTAL’s iCollaborative: https://www.mededportal.org/icollaborative/resource/4180.
Gordon M. A review of the validity and accuracy of self-assessments in health professions training. Acad Med. 1991;66:762–9.
Mattheos N, Nattestad A, Falk-Nilsson E, Attstrom R. The interactive examination: assessing students’ self-assessment ability. Med Educ. 2004;38:378–89.
Isenberg GA, Roy V, Veloski J, Berg K, Yeo CF. Evaluation of the validity of medical students’ self-assessments of proficiency in clinical simulations. J Surg Res. 2015;193:554–9.
Langendyk V. Not knowing that they do not know: self-assessment accuracy of third-year medical students. Med Educ. 2006;40:173–9.
Colbert-Getz JM, Fleishman C, Jung J, Shilkofski N. How do gender and anxiety affect students’ self-assessment and actual performance on a high-stakes clinical skills examination? Acad Med. 2013;88:44–8.
Blanch-Hartigan D. Medical students’ self-assessment of performance: results from three meta-analyses. Patient Educ Couns. 2011;84:3–9.
Angus SV, Vu TR, Willett LL, Call S, Halvorsen AJ, Chaudhry S. Internal medicine residency program directors’ views of the core entrustable professional activities for entering residency: an opportunity to enhance communication of competency along the continuum. Acad Med. 2016. doi:10.1097/ACM.0000000000001419.
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The University of Central Florida Institutional Review Board approved this study as human participant research that is exempt from regulation. Identifiable student self-assessments were never available to the principal investigator. Student self-assessments were available in Qualtrics (an online survey design and delivery system that is password-protected) only to the statistician for analysis after the students completed the psychiatry clerkship, and all final grades were assigned.
Disclosures
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Funding Source
The authors completed this study as part of their academic employment at the University of Central Florida College of Medicine; there was no grant support.
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Klapheke, M., Johnson, T. & Cubero, M. Assessing Entrustable Professional Activities During the Psychiatry Clerkship. Acad Psychiatry 41, 345–349 (2017). https://doi.org/10.1007/s40596-017-0665-9
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DOI: https://doi.org/10.1007/s40596-017-0665-9