Transcript EPAs - Public Health Physicians of Canada

Development of Entrustable
Professional Activities (EPAs) for Public
Health and Preventive Medicine (PHPM)
PHPC CPD Event - May 24, 2015
Kieran Moore MD, CCFP(EM), FCFP, MPH, DTM&H, FRCPC
Program Director, Queen’s University
Brent Moloughney, MD, MSc, FRCPC
Public Health Consultant
Conflict of Interest Disclaimer
No relationship with commercial entities such
as:
 Pharmaceutical organization
 Medical device company
 Communications firm
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Acknowledgements
• PHPM Program Directors across Canada
• Participants at Queen’s Workshop (March
2015)
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Overview
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What are EPAs?
Why EPAs?
Approach to development
Current status
Next steps
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Entrustable Professional Activities (EPAs)
• Capture the work that is central/critical to a
specialty - in aggregate, represent the essential
professional work that defines a discipline.
• Link competencies/milestones to practice in an
integrated/holistic manner
• Be more explicit about assessing and
documenting performance of specific
activities/tasks
• Support graded supervision – entrust the activity
to a trainee to execute once obtained adequate
competence
• Being pursued by multiple disciplines around the
world
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CBME
• Increasing shift to competency-based medical
education (CBME)
– Explicit competencies to be acquired
– Stages of competence development defined by
achievement of competency-based milestones
– More frequent, direct observation to evaluate
• Detailed lists of competencies to be acquired
(Objectives of Training)
– Provide clarity of what is expected
– But,
• Potentially overwhelming for residents and faculty
• Competence requires integration of competencies
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Objectives of Training –
Analytic Approach
ten Cate. ICRE 2013
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EPAs - Synthetic Approach
ten Cate. ICRE 2013
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Royal College
CanMEDS 2015
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Royal College: EPAs and Milestones
• RC intends to use milestones and EPAs to
redesign specialist training and assessment
– Milestone is observable marker of an individual's
ability along a developmental continuum
– EPA is the task that must be accomplished - each EPA
integrates multiple milestones
• Vision for application:
– Use milestones to design educational activities and
teach specific abilities, skills and attitudes
– Assess overall achievement of various milestones
using an EPA
http://www.royalcollege.ca/portal/page/portal/rc/resources/
publications/dialogue/vol15_2/epa_milestones
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EPAs are the tasks
that must be
accomplished,
whereas milestones
are the abilities of
the individual
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Example*
• EPA: Manage an infectious disease outbreak
• Milestones (examples)
– Transition to discipline (post-MD clinical)
• Elicit relevant information for a suspect reportable disease
– Foundations (coursework)
• Describe steps in an outbreak investigation
– Core (early rotations)
• Assume under direct supervision a support role (e.g., case
finding plan; generate case definition; etc.)
– Transition to practice (late rotation)
• Assume under minimal supervision the lead role (e.g.,
declare outbreak; organize team; plan/implement
investigation; etc.)
*Calgary EPA Curriculum
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Initiative Goal
• Establish a national core set of PHPM EPAs
with corresponding milestones that are
supported by case-based learning scenarios
and simulations.
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Path to PHPM EPAs
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PHPM EPAs – draft v1
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‘Optional’ EPAs
• Diversity of PHPM practice that extends beyond
formal government-mandated public health
institutions
• These career paths while mentioned in
introduction to Objectives of Training, not directly
addressed in the competencies or core EPAs
• Strong interest expressed by Program Directors to
develop one or more optional EPAs, e.g.,
– PHPM-oriented clinical practice
– Broader health system leadership/stewardship
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Next Steps
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Further Information
• PHPM EPA development resources:
http://familymedicine.queensu.ca/education/ph
pm/competency_by_design_initiative/resources
• Kieran Moore:
[email protected]
• Brent Moloughney:
[email protected]
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