gms | German Medical Science

Objectives: Entrustable professional activities (EPAs) are observable clinical activities consisting of knowledge, skills and attitudes that can be entrusted to learners over time [1]. EPAs have not yet been used or developed in pharmaceutical education in German-speaking countries. The American Association of Colleges of Pharmacy (AACP) published a list of core EPAs for new pharmacy graduates in 2017 [2]. However, the application of the EPAs for other contexts and countries is limited. Moreover, the structure of these EPAs does not match the EPA structure suggested by Ten Cate and colleagues [1]. Within the scope of an interprofessional training ward in Munich (MIPA), including pharmacy pre-registration students, medical students, and nursing trainees, we aimed to develop and apply pharmaceutical EPAs along with corresponding checklists to assess the students’ ability to perform specific clinical tasks.

Methods: Six steps were required for the development and validation of EPAs:

1.

Identification of pharmaceutical-clinical activities carried out on a ward.

2.

Development of content for EPA description and the associated checklist by a working group of clinical pharmacists through literature review and work analysis.

3.

Refinement of the developed EPA and checklist by an interprofessional consensus group from LMU University Hospital.

4.

Validation of content by an expert group of clinical pharmacists from LMU University Hospital and an independent group of clinical pharmacists across Germany.

5.

Determination of the EPA quality based on the EQual tool [3].

6.

Application of the EPA and checklist in an assessment situation to determine external validity and check for inter-rater reliability.

Results: Three master EPAs were recognized to capture the scope of clinical pharmacist`s services on a ward: “Medication Reconciliation”, “Patient Record Review” and “Discharge Management”. To date, the EPA “Medication Reconciliation” has been fully validated. First, an interprofessional consensus group was held which resulted in a total of 21 annotations, 19 of which were implemented to refine the EPA. In the online content validation survey, experts agreed on the scope and content of the EPA (S-CVI/Ave>0.8). The EPA also demonstrated adequate quality in accordance with the EQual Tool by scoring above the overall threshold score of 4.07, as defined by its authors [3]. Furthermore, it proved to be a suitable instrument for structuring the activity “Medication Reconciliation” in an assessment situation. Sufficient inter-rater reliability was achieved in this context (Cohen’s Kappa coefficient 0.89).

Conclusion: With increasing involvement of clinical pharmacists on the wards, there is a strong need for quality assessment tools. We believe that EPAs have the potential to be excellent tools when determining the quality of clinical-pharmaceutical work of licensed pharmacists as well as pre-registration pharmacists and pharmacy students in educational settings such as MIPA.