gms | German Medical Science

4th Research in Medical Education (RIME) Symposium 2015

19.03-21.03.2015, München

Developing an Entrustable Professional Activity (EPA) “Conducting a ward round” in the surgical and psychiatric-psychosomatic branch. Domain specific versus general aspects

Meeting Abstract

  • corresponding author presenting/speaker Elisa Vietz - Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Esther Beltermann - Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Christian Lottspeich - Klinikum der Universität München, Medizinische Klinik und Poliklinik, Munich, Germany
  • author Teresa Wölfel - Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Martin R. Fischer - Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Ralf Schmidmaier - Klinikum der Universität München, Medizinische Klinik und Poliklinik, Munich, Germany

4th Research in Medical Education (RIME) Symposium 2015. München, 19.-21.03.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP16

doi: 10.3205/15rime35, urn:nbn:de:0183-15rime358

Published: March 12, 2015

© 2015 Vietz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License. You are free: to Share - to copy, distribute and transmit the work, provided the original author and source are credited. See license information at http://creativecommons.org/licenses/by-nc-nd/3.0/.


Outline

Text

Introduction: Ward rounds provide the basis for excellent medical care and are a central element in doctors’ daily routines irrespective of the medical branch. In terms of competency-based medical education, entrustable professional activities (EPAs) have been defined for various medical tasks [1], [2]. Recently, we have analyzed medical competencies and defined an EPA for running a ward round in internal medicine [3]. So far, there is no satisfactory research on the competencies and activities necessary for running a surgical or psychiatric-psychosomatic ward round. This study aims at determining these competencies and integrating them in the respective EPAs. Furthermore, it is aimed to identify domain specific and domain general competencies.

Methods We performed an interview study with surgical and psychiatric-psychosomatic ward staff N=60 of a university hospital and several general hospitals. The ward staff consisted of experts such as surgical, psychiatric and psychosomatic senior physicians, resident physicians, nursing staff and - for psychiatric-psychosomatic wards - psychologists. A semi-structured questionnaire, based on a previous study, was used [3]. The competencies and activities necessary for conducting ward rounds were identified, compared and integrated in EPAs by qualitative content analysis [4], [5].

Results: The analysis shows that skills for communication with the patient and the team, as well as collaborative clinical reasoning are generic competencies in both specialties. Practical skills such as organization are more important for the surgical ward round, while soft skills like teamwork and empathy feature more prominently in psychiatric ward rounds.

Discussion: On the basis of the cross-domain competencies it will be possible to develop a general EPA “Running a ward round” and to implement it in student education. Concerning the domain-specific competencies further research is needed to determine whether they should rather be taught at university or in medical specialist training.


References

1.
Ten Cate O, Young JO. The patient handover as an EPA: adding meaning in teaching and practice. BMJ Qual Saf. 2012;21(Suppl 1):i9-i12. DOI: 10.1136/bmjqs-2012-001213 External link
2.
Royal Australian and New Zealand College of Psychiatrists. EPA Handbook. Melburne: Royal Australian and New Zealand College of Psychiatrists; 2012.
3.
Wölfel T, Beltermann E, Lottspeich C, Vietz E, Fischer MR, Schmidmaier R. How to run a good ward round. Identifying an Entrustable Professional Activitiy "performing ward rounds". (in prep.)
4.
Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken. Weinheim: Deutscher Studienverlag; 2003.
5.
Mulder H, Ten Cate O, Daalder R, Berkvens J. Building a competency-based workplace curriculum around entrustable professional activities: The case of physician assistant training. Med Teach. 2010;32(10):e453-e459. DOI: 10.3109/0142159X.2010.513719 External link