Abstract
Since the publication of the Entrustable Professional Activities (EPAs) project by the Association of American Medical Colleges (AAMC), institutions have been exploring how to integrate and assess EPAs into a pre-existing medical education curricular structure. Here, we describe a systematic approach for achieving this task using the third year Core Clerkships as a model. We utilized the process of Backward Design to integrate the EPAs into our existing third year Core Clerkship Curriculum by creating common student learning outcomes and implementing a standardized assessment strategy. Specifically, our manuscript shares the process we used, barriers we faced, methods to evaluate the changes, our ideas to continue to improve this process in the future, and how other institutions can generalize this process. Our redesign efforts revealed that many perceptors were unable to evaluate student performance on key EPA-based outcomes we identified as appropriate to the third year. This finding has implications for how to begin making Entrustment decisions by helping to better establish where key entrustable performances are best observed and assessed.
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Notes
Constructive alignment has a lot to offer in terms of verifying proper alignment between student learning outcomes, assessments, and structured learning activities (lectures, team-based learning, etc.), but for the purpose of redesigning our third year required Clerkships we preferred the model of Backward Design because the assessments follow from the student learning outcomes. That is, once you have determined what you want a learner to be able to do or understand upon the conclusion of a learning experience, you identify the assessments that would allow you to measure progression toward and achievement of those intended outcomes. Moving forward, we may build on this process by utilizing Constructive Alignment to verify the coherence between our identified student learning outcomes, assessments, and learning activities of our third year required Clerkships. Please note that while Biggs [4] is associated with coining the term Constructive Alignment, this concept was first conceived by Tyler [5] and more fully elaborated by Shuell [6]. Additionally, the framework of Backward Design also encourages the verification of alignment between student learning outcomes, assessments, and instructional activities.
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Acknowledgments
The authors would like to acknowledge the efforts of the University of Cincinnati Core Clerkship Directors, Drs. Krishna P. Athota, MD, Surgery; LeAnn Coberly, MD, Internal Medicine; Robert V. Ellis II, MD, Family Medicine; Peirce W. Johnston, MD, Psychiatry; Corinne E. Lehmann, MD, Pediatrics; John Q. Quinlan MD, Neurology; Amy M. Thompson, MD, Obstetrics and Gynecology as well as the support of Janet Rosing, Andrea Oaks, and the Core Clerkship Coordinators.
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Baker, P., Lukin, L., Neel, R. et al. Using Backward Design to Align the Core Clerkships with the EPAs. Med.Sci.Educ. 26, 759–769 (2016). https://doi.org/10.1007/s40670-016-0305-0
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DOI: https://doi.org/10.1007/s40670-016-0305-0