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As adapted by Ollen ten Cate (2018), the next steps for PA education programs are: Identification of EPA-PAs Create full description of EPA-PAs Map CanMEDS-PA (2015)into each EPA-PA Determine assessment frameworks and rules Record student assessment & entrustment decisions Accommodate flexibility in length/breadth of training Disseminate and publish Canadian EPA-PAs NEXT STEPS Kristen E. Burrows, BSc, BHSc(PA), MSc, CCPA Assistant Dean &, Assistant Clinical Professor McMaster Physician Assistant Education Program Michael G. DeGroote School of Medicine, McMaster University Ian W. Jones, MPAS, PA-C, CCPA, DFAAPA Program Director & Assistant Professor Masters of Physician Assistant Studies Max Rady College of Medicine, University of Manitoba AUTHORS Each EPA is a synthesis of multiple competency domains (i.e. medical expert, communicator, leader, etc.) These EPAs are not meant to encompass specialty-specific competency expectations (i.e. interventional radiology PA) EPAs allow for: continuity and developmental progression of learners Consistent with workplace learning (ongoing) EPA-PAs allows for improved student assessment while allowing students to contribute to patient care EPA framework is useful for promoting competence and accountability 12 Canadian PA EPAs are proposed based on the following: 1. A systematic literature review; 2. Critical review and compilation of EPAs from: Royal College of Physicians and Surgeons of Canada American Academy of Medical Colleges Association of Faculties of Medicine of Canada; 3. Critical review of task lists developed by PA educators in the US and Netherlands. An Entrustable Professional Activity is a key task that an individual can be trusted to perform in a given healthcare context A supervisor can delegate a task to a PA student and observe their performance EPA-PAs are focused on “transition to practice” The Royal College of Physicians & Surgeons of Canada is moving Canadian medical education towards competency by design (CBD) to address gaps in our current education system. CBD focuses on demonstrating learning (knowledge & skill acquisition) through entrustable professional activities (EPAs) & milestones, specific to the stage of training. CBD has been a hallmark of PA education since the inaugural program at Duke University in 1965, as by nature of the profession, PAs should only be delegated a task they have demonstrated competency in. As physician education migrates over to formal CBD learning and assessment, PA education should also be based on formalized professional activities that delineate what skill set is required for entry to practice. Obtain a history & perform a physical examination adapted to the patient’s clinical situation. . Form clinical questions, gather evidence to advance patient care, and communicate results to the patient & medical team. Formulate & prioritize differential diagnoses. Develop & implement patient- centered therapeutic plans within formalized physician & clinical team relationship. Accurately document & report clinical encounters. Recognize a patient requiring immediate care, providing appropriate management & seeking help as needed. Perform procedures identified in the CanMEDS-PA Medical Expert competencies. Participate in continuing professional & patient quality improvement, life-long learning, and scholarship. 12. Practice patient-focused, safe, professional, & competent medical care. Advocate for the patient concerning cultural, community, & social needs in support of positive mental & physical wellness. 1 2 3 5 6 7 9 4 Collaborate in patient care as an inter- professional team member & transition care responsibly. 8 12 Practice patient- focused, safe, professional, & competent medical care. Engage & educate patients on procedures, disease management, health promotion, wellness, & preventative medicine. 10 11 Entrustable Professional Activities for Canadian Physician Assistants Kristen E. Burrows & Ian W. Jones WHAT ARE EPAs? INTRODUCTION DEVELOPMENT OF EPA-PAs BENEFITS OF EPA-PAs
