Workplace-based assessments of entrustable professional activities in a psychiatry core clerkship: an observational study

Pinilla, Severin; Kyrou, Alexandra; Klöppel, Stefan; Strik, Werner; Nissen, Christoph; Huwendiek, Sören (2021). Workplace-based assessments of entrustable professional activities in a psychiatry core clerkship: an observational study. BMC medical education, 21(1), p. 223. BioMed Central 10.1186/s12909-021-02637-4

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Background: Entrustable professional activities (EPAs) in competency-based, undergraduate medical education (UME) have led to new formative workplace-based assessments (WBA) using entrustment-supervision scales in clerkships. We conducted an observational, prospective cohort study to explore the usefulness of a WBA designed to assess core EPAs in a psychiatry clerkship.

Methods: We analyzed changes in self-entrustment ratings of students and the supervisors' ratings per EPA. Timing and frequencies of learner-initiated WBAs based on a prospective entrustment-supervision scale and resultant narrative feedback were analyzed quantitatively and qualitatively. Predictors for indirect supervision levels were explored via regression analysis, and narrative feedback was coded using thematic content analysis. Students evaluated the WBA after each clerkship rotation.

Results: EPA 1 ("Take a patient's history"), EPA 2 ("Assess physical & mental status") and EPA 8 ("Document & present a clinical encounter") were most frequently used for learner-initiated WBAs throughout the clerkship rotations in a sample of 83 students. Clinical residents signed off on the majority of the WBAs (71%). EPAs 1, 2, and 8 showed the largest increases in self-entrustment and received most of the indirect supervision level ratings. We found a moderate, positive correlation between self-entrusted supervision levels at the end of the clerkship and the number of documented entrustment-supervision ratings per EPA (p < 0.0001). The number of entrustment ratings explained 6.5% of the variance in the supervisors' ratings for EPA 1. Narrative feedback was documented for 79% (n = 214) of the WBAs. Most narratives addressed the Medical Expert role (77%, n = 208) and used reinforcement (59%, n = 161) as a feedback strategy. Students perceived the feedback as beneficial.

Conclusions: Using formative WBAs with an entrustment-supervision scale and prompts for written feedback facilitated targeted, high-quality feedback and effectively supported students' development toward self-entrusted, indirect supervision levels.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Geriatric Psychiatry and Psychotherapy
04 Faculty of Medicine > Medical Education > Institute for Medical Education > Assessment and Evaluation Unit (AAE)
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
04 Faculty of Medicine > Medical Education > Institute for Medical Education

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Pinilla, Severin; Klöppel, Stefan; Strik, Werner; Nissen, Christoph and Huwendiek, Sören

Subjects:

300 Social sciences, sociology & anthropology > 370 Education
600 Technology > 610 Medicine & health

ISSN:

1472-6920

Publisher:

BioMed Central

Language:

English

Submitter:

Severin Philipp José Pinilla Isabela

Date Deposited:

11 May 2021 12:02

Last Modified:

16 May 2021 03:04

Publisher DOI:

10.1186/s12909-021-02637-4

PubMed ID:

33882926

BORIS DOI:

10.48350/156013

URI:

https://boris.unibe.ch/id/eprint/156013

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