Entrustment in physician-patient communication: a modified Delphi study using the EPA approach
Abstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementat...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-021-02931-1 |
| _version_ | 1819137517269549056 |
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| author | Ayesha Younas Rehan Ahmed Khan Raheela Yasmin |
| author_facet | Ayesha Younas Rehan Ahmed Khan Raheela Yasmin |
| author_sort | Ayesha Younas |
| collection | DOAJ |
| description | Abstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementation and assessment. This issue can be resolved by treating certain specific patient communication related tasks as acts of entrustment or entrustable professional activities (EPAs). In this study, we aimed to define a competency-based framework for assessing patient physician communication using the language of EPAs. Methods A modified Delphi study was conducted in three stages. The first stage was an extensive literature review to identify and elaborate communication related tasks which could be treated as EPAs. The second stage was content validation by medical education experts for clarity and representativeness. The third stage was three iterative rounds of modified Delphi with predefined consensus levels. The McNemar test was used to check response stability in the Delphi Rounds. Results Expert consensus resulted in development of 4 specific EPAs focused on physician-patient communication with their competencies and respective assessment strategies all aiming for level 5 of unsupervised practice. These include Providing information to the patient or their family about diagnosis or prognosis; Breaking Bad news to the patient or their family; Counseling a patient regarding their disease or illness; Resolving conflicts with patients or their families. Conclusions The EPAs for Physician-patient communication are a step toward an integrative, all-inclusive competency-based assessment framework for patient-centered care. They are meant to improve the quality of physician patient interaction by standardizing communication as a decision of entrustment. The EPAs can be linked to competency frameworks around the world and provide a useful assessment framework for effective training in patient communication. They can be integrated into any post graduate curriculum and can also serve as a self-assessment tool for postgraduate training programs across the globe to improve their patient communication curricula. |
| first_indexed | 2024-12-22T10:52:08Z |
| format | Article |
| id | doaj.art-724b5aa1e4de4004849bd2dcb06a4d58 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-22T10:52:08Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-724b5aa1e4de4004849bd2dcb06a4d582022-12-21T18:28:44ZengBMCBMC Medical Education1472-69202021-09-0121111210.1186/s12909-021-02931-1Entrustment in physician-patient communication: a modified Delphi study using the EPA approachAyesha Younas0Rehan Ahmed Khan1Raheela Yasmin2Department of Medical and Dental Education, Shifa College of Dentistry, Shifa Tameer-e-Millat UniversityIslamic International Medical College, Riphah International UniversityRARE Department, Islamic International Medical College, Riphah International UniversityAbstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementation and assessment. This issue can be resolved by treating certain specific patient communication related tasks as acts of entrustment or entrustable professional activities (EPAs). In this study, we aimed to define a competency-based framework for assessing patient physician communication using the language of EPAs. Methods A modified Delphi study was conducted in three stages. The first stage was an extensive literature review to identify and elaborate communication related tasks which could be treated as EPAs. The second stage was content validation by medical education experts for clarity and representativeness. The third stage was three iterative rounds of modified Delphi with predefined consensus levels. The McNemar test was used to check response stability in the Delphi Rounds. Results Expert consensus resulted in development of 4 specific EPAs focused on physician-patient communication with their competencies and respective assessment strategies all aiming for level 5 of unsupervised practice. These include Providing information to the patient or their family about diagnosis or prognosis; Breaking Bad news to the patient or their family; Counseling a patient regarding their disease or illness; Resolving conflicts with patients or their families. Conclusions The EPAs for Physician-patient communication are a step toward an integrative, all-inclusive competency-based assessment framework for patient-centered care. They are meant to improve the quality of physician patient interaction by standardizing communication as a decision of entrustment. The EPAs can be linked to competency frameworks around the world and provide a useful assessment framework for effective training in patient communication. They can be integrated into any post graduate curriculum and can also serve as a self-assessment tool for postgraduate training programs across the globe to improve their patient communication curricula.https://doi.org/10.1186/s12909-021-02931-1Assessment of communicationCompetency based educationcommunication curriculumEntrustable professional activitiesPostgraduate studiesModified Delphi study |
| spellingShingle | Ayesha Younas Rehan Ahmed Khan Raheela Yasmin Entrustment in physician-patient communication: a modified Delphi study using the EPA approach BMC Medical Education Assessment of communication Competency based education communication curriculum Entrustable professional activities Postgraduate studies Modified Delphi study |
| title | Entrustment in physician-patient communication: a modified Delphi study using the EPA approach |
| title_full | Entrustment in physician-patient communication: a modified Delphi study using the EPA approach |
| title_fullStr | Entrustment in physician-patient communication: a modified Delphi study using the EPA approach |
| title_full_unstemmed | Entrustment in physician-patient communication: a modified Delphi study using the EPA approach |
| title_short | Entrustment in physician-patient communication: a modified Delphi study using the EPA approach |
| title_sort | entrustment in physician patient communication a modified delphi study using the epa approach |
| topic | Assessment of communication Competency based education communication curriculum Entrustable professional activities Postgraduate studies Modified Delphi study |
| url | https://doi.org/10.1186/s12909-021-02931-1 |
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