Perceptions on Entrustable Professional Activities (EPAs) in Psychiatry Among Specialty Trainees

10.6145/jme.202212_26(4).0003

Mei-Feng Huang；Yi-Chun Yeh；Tai-Ling Liu；Wei-Po Chou；Peng-Wei Wang；Cheng-Sheng Chen

competence-based medical education ； entrustable professional activities ； psychiatry speciality ； trainees

Journal of Medical Education

26卷4期（2022 / 12 / 01）

33 - 43

英文

Background: Competence-based medical education (CBME) has been proposed and will lead the paradigm shift in medical education. Entrustable professional activities (EPAs) is one of the operational systems to achieve the goals of CBME. The development of scopes of professional clinical tasks is the first step for EPAs medical education. In this study, we aimed to develop a framework of EPAs specially for psychiatry specialty training and to investigate the perceptions of these EPAs among trainees. Methods: This study combined the methods of expert focus group and questionnaire survey. Experts in the focus group were attending psychiatrists at Kaohsiung Medical University Hospital. A survey questionnaire using Google Forms was distributed to all psychiatric trainees via email. Study participants were all psychiatry specialty trainees in around 35 training institutes, two-thirds of which were general hospitals, while the rest was psychiatric hospitals. Results: A 17 EPAs and a corresponding core competency matrix was developed. The EPA program covers general psychiatric practice, mental capacities consideration, medical conditions and consultation, psychiatric public health, and resident faculty. Agreeable rates of EPAs from trainees ranged from 58% to 100%, with mean = 92%. At least five agreeable EPAs involve public health, diagnostic certificates preparation, electroconvulsive therapy, and care responsibility handover and transition. Conclusions: The Department of Psychiatry of Kaohsiung Medical University developed an EPA program using expert focus group methods. Trainees' perceptions of the EPA revealed high agreeable rates. A few differences exist between experts and trainees. The program provides a sample for further expansion and modification for each training institute.

1. Boyce, P,Spratt, C,Davies, M(2011).Using entrustable professional activities to guide curriculum development in psychiatry training.BMC Med Educ,11,96.
2. Brennan, N,Corrigan, O,Allard, J(2010).The transition from medical student to junior doctor: Today’s experiences of tomorrow’s doctors.Med Educ,44,449-458.
3. Chauhan, VS,Chatterjee, K,Prakash, J(2022).Identifying entrustable professional activities for postgraduation in psychiatry: What should a psychiatrist be able to do?.Ind Psychiatry J,31,49-55.
4. Gillam, S,Maudsley, G(2010).Public health education for medical students: Rising to the professional challenge.J Public Health,32,125-131.
5. Google: Google Forms. 2015. Retrieved from https://www.google.com/forms/.
6. Hsieh, KY,Tsai, KY,Chou, FH(2019).Reduced risk of stroke among psychiatric patients receiving ECT: A population-based cohort study in Taiwan.Psychiatry Res,276,107-111.
7. Huang, CJ,Lin, CH,Wu, JI(2019).The relationship between depression symptoms and anxiety symptoms during acute ECT for patients with major depressive disorder.Int J Neuropsychopharmacol,22,609-615.
8. Hung, EK,Jibson, M,Sadhu, J(2021).Wresting with implementation: A step-by-step guide to implementing entrustable professional activities (EPAs) in psychiatry residency programs.Acad Psychiatry,45,210-216.
9. Jaykaran(2011).How to increase response rate to a questionnaire study?.Indian J Pharmacol,43,93-94.
10. Keshtkar, M,Ghanizadeh, A,Firoozabadi, A(2011).Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for the treatment of major depressive disorder, a randomized controlled clinical trial.J ECT,27,310-314.
11. Leach, DC(2000).Evaluation of competency: An ACGME perspective. Accreditation council for graduate medical education.Am J Phys Med Rehabil,79,487-489.
12. Lin, CH,Huang, CJ,Chen, CC(2018).ECT has greater efficacy than fluoxetine in alleviating the burden of illness for patients with major depressive disorder: A Taiwanese pooled analysis.Int J Neuropsychopharmacol,21,63-72.
13. Lin, CH,Yang, WC,Chen, CC(2020).Comparison of the efficacy of electroconvulsive therapy (ECT) plus agomelatine to ECT plus placebo in treatment-resistant depression.Acta Psychiatr Scand,142,121-131.
14. Lin, HS,Lin, CH(2019).Early improvement in HAMD17 and HAMD-6 scores predicts ultimate response and remission for depressed patients treated with fluoxetine or ECT.J Affect Disord,245,91-97.
15. Lockyer, J,Carraccio, C,Chan, MK(2017).Core principles of assessment in competency-based medical education.Med Teach,39,609-616.
16. McGaghie, WC,Miller, GE,Sajid, AW(1978).Competency-based curriculum development on medical education: An introduction.
17. Pinilla, S,Lenouvel, E,Strik, W(2020).Entrustable professional activities in psychiatry: A systematic review.Acad Psychiatry,44,37-45.
18. Powell, DE,Carraccio, C(2018).Toward competency-based medical education.N Engl J Med,378,3-5.
19. Ten Cate, O(2013).Nuts and bolts of entrustable professional activities.J Grad Med Educ,5,157-158.
20. Ten Cate, O,Tobin, S,Stokes, ML(2017).Bringing competencies closer to day-to-day clinical work through entrustable professional activities.Med J Aust,206,14-16.
21. Weiss, A,Ozdoba, A,Carroll, V(2016).Entrustable professional activities: Enhancing meaningful use of evaluations and milestones in a psychiatry residency program.Acad Psychiatry,40,850-854.
22. Young, JQ,Hasser, C,Hung, EK(2018).Developing end-of-training entrustable professional activities for psychiatry: Results and methodological lessons.Acad Med,93,1048-1054.
23. Young, JQ,McClure, M(2020).Fast, easy, and good: Assessing entrustable professional activities in psychiatry residents with a mobile app.Acad Med,95,1546-1549.