gms | German Medical Science

Introduction: In the Aachen model curriculum, the last course before the Practical Year (semesters 11 and 12) is the so called Clinical Competence Course. After the course, students should be able to name and evaluate differential diagnoses for common symptoms and use clinical reasoning skills. Currently, lectures are used predominantly in the course and the exam consists solely of MC questions.

The course is being restructured to include more practical and clinical reasoning skills both in teaching and testing. To this end, Entrustable Professional Activities (EPAs) will be implemented.

Objectives: As the EPAs will represent what clinicians expect students to know and be able to do in their Practical Year, clinicians must be included in formulating them. Students and stake-holders within the Medical Faculty should also be involved in order to ensure wide acceptance of the concept.

Materials & Methods: We identified our regular medical didactics courses which are aimed specifically at clinicians as a suitable platform for the development of such EPAs. During the course, participants learn about EPAs and then apply this new knowledge by formulating them in small groups. Due to the nature of our courses, these groups are usually multidisciplinary and include individuals already highly involved in teaching as well as relative novices.

In a second step, student representatives were invited to review the EPAs. In a third step, stake-holders such as departmental chairs will be invited in order to reach a broad consensus on the EPAs to be implemented.

Results: We found the multidisciplinary, diverse-background approach to work well. Consensus on a useful skill set which students should possess was reached reasonably fast in the small working groups and EPAs were not overly specific.

The students that were asked to review and discuss the EPAs generally agreed that they were useful and, most importantly, achievable before entering the Practical Year.

Conclusion: Nesting the development of EPAs in a course on clinical teaching is a feasible, resource-effective approach. We were able to include those clinicians that might not participate in such a task otherwise. Forming multidisciplinary groups to work on such tasks is often difficult due to conflicting schedules in clinical work; this was also fostered by embedding it in a course.