Entrustable professional activities for Junior Brazilian Medical Students in community medicine

Abstract Background Entrustable professional activities (EPAs) have been defined to promote the workplace participation of undergraduate medical students, generally in the context of high-income countries with a focus on the secondary and tertiary health care sectors. These EPAs have limited applica...

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Main Authors: Ieda Francischetti, Ylva Holzhausen, Harm Peters
Format: Article
Language:English
Published: BMC 2022-10-01
Series:BMC Medical Education
Subjects:
Online Access:https://doi.org/10.1186/s12909-022-03762-4
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author Ieda Francischetti
Ylva Holzhausen
Harm Peters
author_facet Ieda Francischetti
Ylva Holzhausen
Harm Peters
author_sort Ieda Francischetti
collection DOAJ
description Abstract Background Entrustable professional activities (EPAs) have been defined to promote the workplace participation of undergraduate medical students, generally in the context of high-income countries with a focus on the secondary and tertiary health care sectors. These EPAs have limited applicability to training and health care contexts in low- to middle-income countries that have a focus on primary health care, for instance, the context of community medicine. The purpose of this article is to report the process and results of defining EPAs for undergraduate medical training in a community health care setting. Methods A modified Delphi study was performed to develop EPAs for the training of medical students in community medicine during their first and second years of education at the Marília Medical School (FAMEMA), Brazil. The supervision level was operationalized in terms of a student’s ability to perform the EPA autonomously in an effective and safe manner with supervision readily available on request. Panellists (9 physicians and 6 nurses) rated the completeness of the proposed list of EPAs and EPA categories on four-point Likert scales. The threshold for consensus among panellists was a mean content validity index of at least 80%. Results Consensus was reached after two Delphi rounds, resulting in 11 EPAs for undergraduate medical education and training in community medicine. These EPAs were organized into three overarching EPA domains: integrality of care for individual health needs in all phases of the life cycle (5 EPAs), integrality of care for family health needs (3 EPAs), and integrality of care for community health needs (3 EPAs). For each EPA, descriptions of the following categories were created: title; specifications and limitations; conditions and implications of the entrustment decision; knowledge, skills, and attitudes; links to competencies; and assessment sources. Conclusion The resulting 11 EPAs for training medical students in community medicine expand the application of the EPA framework to both early undergraduate medical education and the context of primary health care. This report can support and guide other medical schools in their attempts to train students in primary health care contexts and to incorporate EPAs into their curricula.
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spelling doaj.art-784306954f894ab599a5300bc8eb50752022-12-22T04:34:43ZengBMCBMC Medical Education1472-69202022-10-0122111210.1186/s12909-022-03762-4Entrustable professional activities for Junior Brazilian Medical Students in community medicineIeda Francischetti0Ylva Holzhausen1Harm Peters2Dieter Scheffner Center for Medical Education and Educational Research Charité - Universitätsmedizin Berlin, Dean?s Office of Study AffairsDieter Scheffner Center for Medical Education and Educational Research Charité - Universitätsmedizin Berlin, Dean?s Office of Study AffairsDieter Scheffner Center for Medical Education and Educational Research Charité - Universitätsmedizin Berlin, Dean?s Office of Study AffairsAbstract Background Entrustable professional activities (EPAs) have been defined to promote the workplace participation of undergraduate medical students, generally in the context of high-income countries with a focus on the secondary and tertiary health care sectors. These EPAs have limited applicability to training and health care contexts in low- to middle-income countries that have a focus on primary health care, for instance, the context of community medicine. The purpose of this article is to report the process and results of defining EPAs for undergraduate medical training in a community health care setting. Methods A modified Delphi study was performed to develop EPAs for the training of medical students in community medicine during their first and second years of education at the Marília Medical School (FAMEMA), Brazil. The supervision level was operationalized in terms of a student’s ability to perform the EPA autonomously in an effective and safe manner with supervision readily available on request. Panellists (9 physicians and 6 nurses) rated the completeness of the proposed list of EPAs and EPA categories on four-point Likert scales. The threshold for consensus among panellists was a mean content validity index of at least 80%. Results Consensus was reached after two Delphi rounds, resulting in 11 EPAs for undergraduate medical education and training in community medicine. These EPAs were organized into three overarching EPA domains: integrality of care for individual health needs in all phases of the life cycle (5 EPAs), integrality of care for family health needs (3 EPAs), and integrality of care for community health needs (3 EPAs). For each EPA, descriptions of the following categories were created: title; specifications and limitations; conditions and implications of the entrustment decision; knowledge, skills, and attitudes; links to competencies; and assessment sources. Conclusion The resulting 11 EPAs for training medical students in community medicine expand the application of the EPA framework to both early undergraduate medical education and the context of primary health care. This report can support and guide other medical schools in their attempts to train students in primary health care contexts and to incorporate EPAs into their curricula.https://doi.org/10.1186/s12909-022-03762-4Entrustable professional activitiesUndergraduate medical educationCommunity medicine
spellingShingle Ieda Francischetti
Ylva Holzhausen
Harm Peters
Entrustable professional activities for Junior Brazilian Medical Students in community medicine
BMC Medical Education
Entrustable professional activities
Undergraduate medical education
Community medicine
title Entrustable professional activities for Junior Brazilian Medical Students in community medicine
title_full Entrustable professional activities for Junior Brazilian Medical Students in community medicine
title_fullStr Entrustable professional activities for Junior Brazilian Medical Students in community medicine
title_full_unstemmed Entrustable professional activities for Junior Brazilian Medical Students in community medicine
title_short Entrustable professional activities for Junior Brazilian Medical Students in community medicine
title_sort entrustable professional activities for junior brazilian medical students in community medicine
topic Entrustable professional activities
Undergraduate medical education
Community medicine
url https://doi.org/10.1186/s12909-022-03762-4
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