Multi-stakeholder validation of entrustable professional activities for a family medicine care of the elderly residency program: A focus group study

ABSTRACT

Entrustable Professional Activities (EPAs) have become widely used within Competency-Based Medical Education (CBME) for the training and evaluation of residents. Little is known about the effectiveness of incorporating multiple stakeholder groups in the validation of EPAs. Here, we seek to validate an EPA framework developed for the University of Manitoba Care of the Elderly Enhanced Skills program using online focus groups consisting of five stakeholder groups. Participants were recruited to take part in one of five online focus groups, one for each stakeholder group (physician faculty, residents, non-physician healthcare professionals, administrators/managers, and patients). Each group met one time for 90 minutes over ZOOM_®. The themes arising from stakeholder feedback suggest that successful EPAs must neither be too specific nor too expansive in scope, clearly delineate appropriate means of evaluation, and indicate specific clinical settings in which each EPA should be evaluated. Cross-cutting themes included requiring trainees to collaborate with other professionals when it would optimize patient care, and preparing trainees to advocate for their patients’ health (Advocacy). The present study demonstrates that multi-stakeholder analysis yields diverse feedback that can help make EPAs more clear, easier to use in evaluation, and more socially accountable.

KEYWORDS:

• Entrustable Professional Activities
• Competency-based medical education
• Focus group
• Stakeholder
• Validation

Acknowledgements

We thank the Winnipeg Regional Health Authority as well as its Local Health Interest Groups for assisting in the distribution of study invitations to relevant stakeholders.

Disclosure statement

BC and DF were medical students at the Max Rady College of Medicine at the time of the study. PS is a board member of Age and Opportunity (unremunerated) and has received speaking honorarium from the University of Ottawa. JF has no competing interests to declare.

Availability of data and materials

Full survey results have been made available by the authors on Zenodo (DOI: 10.5281/zenodo.6385646)

Ethics approval and consent to participate

This research study was conducted in accordance with the Declaration of Helsinki. All participants were required to sign a consent form in advance of their focus group meeting. The final study protocol, survey guide and data collection tools were approved prior to the commencement by the University of Manitoba Health Research Ethics Board (research study HS24748).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The work was supported by the Max Rady College of Medicine, University of Manitoba .