A Systems-Based Approach to Curriculum Development and Assessment of Core Entrustable Professional Activities in Undergraduate Medical Education
In 2014, the AAMC launched a pilot project with 10 institutions to test the feasibility of implementing 13 Core Entrustable Professional Activities (EPAs) for Entering Residency.
The Curriculum and Assessment (C-A) group of the pilot has proposed using a systems-based approach (SBA) as a framework for the development and implementation of EPAs in undergraduate medical education (UME). Based on the seminal concepts of systems thinking, five process-oriented steps define the system, describe a pathway to goal accomplishment, develop connections among people responsible for implementation, prepare for work activities, and plan for continuous quality improvement.
The systems-based approach proved to be very well-suited to the specific challenges of implementing EPAs within an existing curriculum. Our results with EPA 11 provided an early indicator of a successful longitudinal and fully integrated approach to educating and assessing students in obtaining informed consent.
Pilot project institutions are endorsing the SBA to develop and implement EPAs in UME to encourage scalability, replication, or adaptation, as needed locally and across institutional sites. While the work of the Core EPA pilot project is ongoing, we introduce the SBA to foster early adoption by institutions interested in incorporating EPAs into their current undergraduate medical education programs.
KeywordsCore Entrustable Professional Activities for Entering Residency (EPAs) Systems-based approach to assessment (SBA) Undergraduate medical education (UME) Informed consent EPA 11
The authors wish to thank Meenakshy Aiyer, MD, Beth Baron, MD, Colleen Gillespie, PhD, Michael L. Schwartz, PhD, Eduard E. Vasilevskis, MD, MPH, Mark Hormann, MD, Matthew Emery, MD, of the Curriculum and Assessment Group and our colleagues from the ten member institutions of the AAMC Core EPA Pilot Project; faculty at the Harvard Macy Institute course, A Systems Approach to Assessment in Health Professions Education; and those who have lent inspiration and support to us through their work with the AAMC at various times during this project: Robert Englander, MD, Carol Aschenbrener, MD, Maryellen Gusic, MD, and Janet Bull, MA.
AAMC Core EPAs for Entering Residency Pilot Project Curriculum and Assessment Group Members:
Meenakshy Aiyer, MD, University of Illinois College of Medicine at Peoria
Beth Baron, MD, Columbia University College of Physicians and Surgeons
Teresa J. Carter, MA, EdD, Virginia Commonwealth University School of Medicine
Matthew Emery, MD, Michigan State University College of Human Medicine
Colleen Gillespie, PhD, New York University School of Medicine
Mark Hormann, MD, University of Texas Health Science Center at Houston
Vivian Obeso, MD, Florida International University Herbert Wertheim College of Medicine
Carrie Phillipi, MD, PhD, Oregon Health & Science University School of Medicine
Michael L. Schwartz, PhD, Yale School of Medicine
Edward Vasilevskis, MD, Vanderbilt University School of Medicine
Sponsorship and support of the work of the Core EPA Pilot Project come from the Association of American Medical Colleges, Washington, DC, and the ten member institutions of the pilot project.
Compliance with Ethical Standards
Conflict of Interest
The authors declare they have no conflicts of interest.
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