Multi-stakeholder validation of Entrustable Professional Activities in FM-Care of the Elderly and RCPSC Geriatrics

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Fisk, Derek
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Entrustable Professional Activities (EPAs) have become widely used within Competency-Based Medical Education (CBME) for the training and evaluation of residents. Little is known about the effectiveness of incorporating multiple stakeholder groups in the validation of EPAs. Through online focus groups consisting of five distinct stakeholder groups, we seek to validate two EPA frameworks: one for the University of Manitoba Care of the Elderly (CoE) Enhanced Skills program, and one for Canadian Geriatrics Specialty Programs. Participants were recruited to take part in one of five online focus groups, one for each stakeholder group (physician faculty, residents, non-physician healthcare professionals, administrators/managers, and patients). Each group met one time for 90 minutes over ZOOM. Meeting transcripts were coded using NVivo using codes that were formulated iteratively by the research team. The themes arising from stakeholder feedback suggest that successful EPAs must neither be too specific nor too expansive in scope, clearly delineate appropriate means of evaluation, and indicate specific clinical settings in which each EPA should be evaluated. Cross-cutting themes included requiring trainees to collaborate with other professionals when it would optimize patient care, and preparing trainees to advocate for their patients' health (Advocacy). Stakeholders also brought forth a variety of ideas that could be used to formulate new CoE and Geriatrics EPAs, and reflected on how the frameworks contrasted the two disciplines. The present study demonstrates that multi-stakeholder analysis yields diverse feedback that can help make EPAs clearer, easier to use in evaluation, and more socially accountable.
Geriatrics, ntrustable Professional Activities