APPD 2012 Spring Meeting · APPD 2012 Spring Meeting ... – Partnerships beyond Peds (AAMC, NBME)...
Transcript of APPD 2012 Spring Meeting · APPD 2012 Spring Meeting ... – Partnerships beyond Peds (AAMC, NBME)...
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APPD 2012 Spring Meeting
The Brink of a New Era in
Pediatric Medical Education: Will We Transform our Future?
Carol Carraccio, MD,MA
Director, Competency-based Assessment Programs American Board of Pediatrics
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• Carol Carraccio has nothing to disclose
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Why a New Era?
• The Pediatrics Community is in a pivotal position to connect initiatives whose “whole” >> “the sum of its parts” – New Accreditation System coupled with a
forward thinking RC – APPD LEARN – IIPE Partnership – PD School – Partnerships beyond Peds (AAMC, NBME) – Education as a continuum rather then silos
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Building Blocks for the Continuum
• Milestones
• EPAs
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Pediatrics Milestone Project
• Initiative spearheaded by ACGME and ABP • Charge:
– Refine the 6 ACGME competencies in the context of the specialty
– Define expected performance levels by year of training
– Identify or develop tools to assess performance
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Where Are We Now?
• Completed the first of the 3 parts of the charge • Milestone Project document sent to Program
Directors • A pdf version is available on the ABP website at:
https://www.abp.org/abpwebsite/publicat/mileston
es.pdf
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What Have We Learned So Far? APPD Survey
Strongly Disagree/ Disagree
Neutral Strongly Agree/ Agree
Helpfulness of Background (n = 124)
5.3% 18.4% 59.6%
Likely to Pursue References (n=114)
14.1% 32.5% 53.47%
Yes No
Interest in Collaboration to Study Milestones (n=115)
71.8% 28.2%
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What Have We Learned So Far?
• Responses to open-ended questions – Concerns:
• Length/practicality • Educational jargon
– How PDs and APDs are using them
• Faculty development • Semi-annual reviews • Remediation • Incorporating them into assessments • Setting ILP goals
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Where Are We Going?
• Not very far without your help
• Please engage with us in studying the milestones and EPAs
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Studying Milestones & EPAs
• The Perfect Example of A Challenge Bringing Lots of Opportunities – Collaboration – Our learning & professional development – Being part of something bigger – Educational innovation – Informing and transforming the future of
medical education
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So How Do We Get There?
• With a Vision, a Strategic Plan, and a
Collaborative and Coordinated Effort
• Through partnerships – APPD LEARN- IIPE – NBME Pilot Project – With colleagues across the educational
continuum
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What Direction Do We Take?
• Study specific milestones – When do learners demonstrate the behaviors
described? – Learning roadmap & formative feedback
• Study the integration of behaviors across competencies – Is the learner a “good doctor”? – Reframe and ground the competencies in a
clinical context (EPAs)
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“Entrustable Professional Activities”
• Professional life activities that define a specialty • Ground the competencies in our everyday work
(competencies in context) • Activities lead to some observable outcome • Complexity of these activities requires an
integration of knowledge, skills and attitudes across competency domains
• Example: Care of the well newborn
Ten Cate O, Scheele F. Competency-based postgraduate training: Can we bridge the gap
between theory and clinical practice. Acad Med;2007:82:542-547
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The Value of EPAs
• Can be mapped to all competencies and
judiciously mapped to specific sub-competencies and their milestones
• Look at assessment from a different perspective that complements the view from the level of milestones
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Milestones + EPAs: Critical Combination for Assessment
• Milestones assess how well a learner can accomplish some smaller part of a competency – A granular approach that is helpful for
feedback & remediation
• EPAs integrate competencies within a clinical context and assess clusters of behaviors – A holistic approach to insure that one can put
all of the pieces together to care for patients
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The Value of EPAs
• New and valuable perspective on assessment of competencies – ENTRUSTMENT
• Can this learner practice this EPA without direct supervision?
• What level of supervision is necessary? • More intuitive question/answer than whether
someone is competent in PBLI, SBP…
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EPAs: Getting Them Right
• Generic language in new RC requirements that
refers to EPAs • Survey of APPD Membership
– 6 questions – Draft list
• What’s missing? • What should be omitted?
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Take Home Messages
• Milestones and EPAs complement each other and the combination is critical to meaningful assessment of learners
• Collaborations and partnerships to learn from what we are doing is the only path forward to true innovation and transformation
• We need your help to light the way
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Thank You!