The development of a framework of entrustable professional activities for the intern year in Ireland
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RESEARCH ARTICLE
Open Access
The development of a framework of entrustable professional activities for the intern year in Ireland Emily O’Dowd1,2 , Sinéad Lydon2,3* , Paul O’Connor1,2 , Josephine Boland4 , Gozie Offiah5 Dara Byrne2,3
and
Abstract Background: Entrustable Professional Activities (EPAs) are units of professional practice that capture essential competencies in which trainees must become proficient before undertaking them independently. EPAs provide supervisors with a solid justification for delegating an activity to trainees. This study aimed to develop and ensure face validity of a set of EPAs for junior doctors in the first year of clinical practice in the Republic of Ireland. Methods: An iterative eight stage consensus building process was used to develop the set of EPAs. This process was based on international best practice recommendations for EPA development. A series of surveys and workshops with stakeholders was used to develop a framework of EPAs and associated competencies. An external stakeholder consultation survey was then conducted by the Irish Medical Council. The framework of EPAs was then benchmarked against the 13 core EPAs developed by the Association of American Medical Colleges (AAMC). Results: A framework of seven EPAs, and associated competencies resulted from this study. These EPAs address all core activities that junior doctors should be readily entrusted with at the end of the intern year, which is the first year of clinical practice in the Republic of Ireland. Each EPA contains a series of defined competencies. The final EPAs were found to be comparable to the AAMC core EPAs for entering residency. Conclusions: A framework of EPAs for interns in Ireland that are appropriate for the intern year has been developed by key stakeholders. The implementation of the EPAs in practice is the next step, and is likely to result in an improved intern training process and increased patient safety. Keywords: Graduate medical education, Entrustable professional activities, Competency-based medical education, Medical education, Medical internship
Background Evidence suggests that upon entering the workplace, junior doctors often lack the necessary skills to care for patients and feel unprepared for independent practice [1–6]. The experiences of junior doctors vary greatly depending * Correspondence: [email protected] 2 Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland 3 School of Medicine, National University of Ireland Galway, Galway, Ireland Full list of author information is available at the end of the article
on the settings within which they are placed [7, 8]. The quality of training and supervision trainees receive during their first year of practice varies between medical teams and hospitals, and likely contributes to the high level of stress and burnout in junior doctors in the Republic of Ireland [9, 10], and internationally [11, 12]. It is also important to acknowledge that junior doctors do not all necessarily
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