Artikel
Development of EPA for the final year clerkship: Nesting from existing national entry into residency EPAs
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Autoren
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Marc Julian Roth
- Charité – Universitätsmedizin Berlin, Dieter Scheffner Center for Medical Education, Berlin, Deutschland
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Friederike Bennett
- Charité – Universitätsmedizin Berlin, Dieter Scheffner Center for Medical Education, Berlin, Deutschland
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Ulrike Bachmann
- Charité – Universitätsmedizin Berlin, Department of Emergency and Acute Medicine, Berlin, Deutschland
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Maximilian Sehn
- Charité – Universitätsmedizin Berlin, Department of General and Visceral Surgery, Berlin, Deutschland
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Ylva Holzhausen
- Charité – Universitätsmedizin Berlin, Dieter Scheffner Center for Medical Education, Berlin, Deutschland
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Harm Peters
- Charité – Universitätsmedizin Berlin, Dieter Scheffner Center for Medical Education, Berlin, Deutschland
| Veröffentlicht: | 11. September 2023 |
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Gliederung
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Objective: Core entrustable professional activities (EPAs) for entry into residency (CEPARs) have been defined for several countries, including Germany. There’s little information in the literature on how to adapt these EPAs, a process called nesting, to the training of medical students in their final clerkship year. This study reports on the process and results of nesting EPAs of the medical final clerkship year from a set of national entry into residency EPAs.
Methods: This study was conducted at the Charité – Universitätsmedizin Berlin, Germany. The final clerkship year consists of 3 rotations, one in internal medicine, one in surgery and one elective. The starting point was a set of 14 national CEPARs [https://nklm.de/zend/menu]. The focus was on nesting EPAs for the internal medicine and surgery rotations. The nesting process was carried out by a writing team consisting of educational and discipline experts.
Results: Of the 14 national CEPARs, 11 were considered to be included in the set of final clerkship year EPAs in both disciplines. For the EPA “performing medical procedures”, 11 procedures were incorporated in both, plus 10 additional procedures for surgery. The supervision levels for the national CEPAR are set at III.c (carry out, only key findings checked, supervisor readily available). The designated supervision levels at the end of the final clerkship year were often markedly lower. 2x II.a (carry out with a physician), 1x II.b (carry out with a physician watching), 4x III.a (carry out without a physician watching, most findings checked), 3x III.b (carry out without a physician watching, only key findings checked), and for the procedures: 5x II.a, 7x II.b, 0x III.a, 9x III.b resepectively.
Discussion: The nested EPAs for the final clerkship show substantial differences from the expectations formulated in the national CEPARs. Closing this gap will be a future task, either by lowering the expectation in the CEPARs or by improving the training that medical students receive.
Take home message: In our context, there is a substantial gap between the EPAs for entry into residency and the range of supervision levels expected at the end of the medical final clerkship year.
