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Investigación en Educación Médica

2022, Number 44

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Inv Ed Med 2022; 11 (44)

Progressive care residency program based on entrustable professional activities

Silberman P, López E, García AS, Skoumal G, De Socio D, Maskaric ME

Language: Spanish
References: 33
Page: 46-57
PDF size: 519.10 Kb.


ABSTRACT

Introduction: Progressive care (PC) can be defined as the organization of the patient’s medical and nursing care according to his or her needs, from admission to outpatient follow-up. A program for a PC residency based on entrustable professional activities (EPA) was designed.
Objective: To describe the process of identification, development, and validation of EPA for the PC residency program.
Method: A theory review on progressive care was made to define the professional profile of the specialist. EPA for the program were drafted. Validation was achieved through the Delphi method in two rounds where 24 professionals participated. Each EPA was consulted for its representativity and indispensability, keeping only those that reached 70% of agreement. The completeness of the learning scenarios was also evaluated. In the second Delphi round, EPA that did not reach 70% of the agreement were submitted, including suggested drafting modifications.
Results: A PC specialist understands the hospital as a set of instruments and tools that integrate and approach the patient, and he or she uses them to manage patient care throughout every stage of treatment. 52 EPA were defined and organized in 9 learning scenarios, according to the PC professional profile established. Of the 52 evaluated EPA, 47 reached 70% of representativity and indispensability. The 5 remaining EPA were submitted to the second Delphi round after modifications, achieving representativity in 3 of them.
Conclusions: The education of health care professionals is leaning towards competency-based programs that allow learners to achieve goals in different moments of their training, according to their needs.


REFERENCES

  1. Estructura organizativa. Decisión Administrativa 384/2021[Internet] 19 de marzo de 2015. [Consultado 24 Mar 2022]Argentina. Disponible en https://bit.ly/3C9up8n

  2. Campos GWS. Equipes de referência e apoio especializadomatricial: um ensaio sobre a reorganização dotrabalho em saúde. Ciênc Saúde Colet. 1999;4(2):393-403.https://doi.org/10.1590/S1413-81231999000200013

  3. Organización Panamericana de la Salud. La transformaciónde la gestión de hospitales en América Latina y el Caribe.Washington, Estados Unidos: OPS 2001. 365 p.

  4. Schiavone M, Mazza P, Cordero L. Internación por cuidadosprogresivos: Propuesta metodológica para su implementaciónen un hospital general de agudos. Rev. Asoc. Méd.Argent. 2011;124(3):17-23.

  5. Ingram R. Progressive patient care. Can J Comp Med VetSci [Internet]. 1960 [Consultado 22 Mar 2022];24(4):134-136.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1582608/

  6. Silberman P, Medina A, Díaz Bazán J, López E, Dursi C.Políticas de planificación y gestión del talento humano delMinisterio de Salud de Argentina durante la pandemia deCOVID-19. Rev. argent. salud públ [Internet]. 2020 [Consultado28 Feb 2022]. 12;Supl COVID-19: e11. Disponibleen: https://rasp.msal.gov.ar/index.php/rasp/article/view/71

  7. Powell DE, Carraccio C. Toward Competency-Based MedicalEducation. N Engl J Med. 2018;378(1):3-5. doi: 10.1056/nejmp1712900. PMID: 29298154

  8. Resolución 1993/2015. [Internet] de 02 de noviembre de2015. [Consultado 24 Mar 2022] Argentina. Disponible en:https://bit.ly/3BBKWk0

  9. Duré I, Daverio D, Dursi C. Planificación y Gestión del SistemaNacional de Residencias (SNR) en Argentina. [Internet]Buenos Aires: Observatorio de Recursos Humanos enSalud- Ministerio de Salud de la Nación; 2013 [Consultado el25 de febrero de 2022]. Disponible en: https://bit.ly/3flCP3p

  10. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, etal. Health professionals for a new century: transformingeducation to strengthen health systems in an interdependentworld. Lancet. 2010. 4;376(9756):1923-58. DOI: 10.1016/S0140-6736(10)61854-5

  11. López MJ, Melo de Andrade MV, Domínguez Torres LC,Durán Perez VD, Durante E, Francischetti I, et al. Basesconceptuales de las actividades profesionales a confiar parala educación de profesionales de la salud en Latinoamérica.Educación Médica. 2022;22(1):100714. https://doi.org/10.1016/j.edumed.2022.100714

  12. Ten Cate O. A primer on entrustable professional activities.Korean J Med Educ. 2018;30(1):1-10. DOI: 10.3946/kjme.2018.76

  13. Ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der SchaafM. Curriculum development for the workplace using EntrustableProfessional Activities (EPAs): AMEE Guide No. 99. Med Teach.2015;37(11):983-1002. DOI: 10.3109/0142159X.2015.1060308

  14. Carraccio C, Englander R, Gilhooly J, Mink R, Hofkosh D,Barone MA, et al. Building a framework of entrustable professionalactivities, supported by competencies and milestones,to bridge the educational continuum. Acad Med.1992;2017(3):324-330. doi: 10.1097/ACM.0000000000001141.

  15. Ten Cate O. Entrustability of professional activities andcompetency-based training. Med Educ. 2005;39(12):1176-7. doi: 10.1111/j.1365-2929.2005.02341.x. PMID: 16313574.

  16. Swing SR. Assessing the ACGME general competencies:general considerations and assessment methods. Acad EmergMed. 2002;9:1278-88. doi: 10.1111/j.1553-2712.2002.tb01588.x.

  17. Soto-Aguilera CA, Robles-Rivera K, Fajardo-Ortiz G, Ortiz-Montalvo A, Hamui-Sutton A. Actividades profesionales confiables(APROC): un enfoque de competencias para el perfilmédico. FEM. 2016; 19 (1): 55-62. [Consultado 7 jun 2022]. Disponibleen: https://scielo.isciii.es/pdf/fem/v19n1/revision.pdf

  18. O’Dowd E, Lydon S, O’Connor P, Madden C, Byrne D. Asystematic review of 7 years of research on entrustable professionalactivities in graduate medical education, 2011-2018.Med Educ. 2019;53(3):234-249. DOI: 10.1111/medu.13792

  19. Watson A, Leroux T, Ogilvie-Harris D, Nousiainen M, FergusonPC, Murnahan L, et al. Entrustable Professional Activitiesin Orthopaedics. JBJS. 2021;6(2):e20.00010. DOI:10.2106/JBJS.OA.20.00010

  20. Hennus MP, Nusmeier A, van Heesch GGM, Riedijk MA,Schoenmaker NJ, Soeteman M, et al. Development of entrustableprofessional activities for paediatric intensivecare fellows: A national modified Delphi study. PLoS One.2021;16(3):e0248565. DOI: 10.1371/journal.pone.0248565

  21. Moll-Khosrawi P, Ganzhorn A, Zöllner C, Schulte-Uentrop L.Development and validation of a postgraduate anaesthesiologycore curriculum based on Entrustable Professional Activities:a Delphi study. GMS J Med Educ. 2020;37(5):Doc52.DOI: 10.3205/zma001345

  22. Harris A, P, Taylor R, Thielke R, Payne J, Gonzalez N, CondeJG. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providingtranslational research informatics support. J BiomedInformat. 2009;42(2):377-381. DOI: 10.1016/j.jbi.2008.08.010

  23. Wisman-Zwarter N, van der Schaaf M, Ten Cate O, JonkerG, van Klei WA, Hoff RG. Transforming the learning outcomesof anaesthesiology training into entrustable professionalactivities: A Delphi study. Eur J Anaesthesiol. 2016;33(8):559-67. DOI: 10.1097/EJA.0000000000000474

  24. Potts JR. 3rd. Assessment of Competence: The AccreditationCouncil for Graduate Medical Education/Residency ReviewCommittee Perspective. Surg Clin North Am. 2016;96(1):15-24. DOI: 10.1016/j.suc.2015.08.008

  25. Durán V, Sánchez-Mojica C, Esqueda-Nuñez R, Hamui-Sutton A. Matriz MEDAPROC ¿Cómo compatibilizar elcurrículo con las Actividades Profesionales Confiables(APROC) y las competencias? [Internet] En: VI CongresoInternacional de Educación Médica del 12 al 16 de junio de2018, Mazatlán, Sinaloa. 2018. Folio C-108. Disponible en:https://bit.ly/3r9WWEB

  26. Hamui-Sutton A, Varela-Ruiz M, Ortiz-Montalvo A, Torruco-García U. Las actividades profesionales confiables: unpaso más en el paradigma de las competencias en educaciónmédica. Rev. Fac. Med. (Méx.) [Internet]. 2015 [Consultadoel 28 de marzo de 2022];58(5):24-39. Disponible en: https://bit.ly/3xRobHR

  27. Amare EM, Siebeck M, Sendekie TY, Fischer MR, BerndtM. Development of an Entrustable Professional Activities(EPA) Framework to Inform Surgical ResidencyTraining Programs in Ethiopia: A Three-round NationalDelphi Method Study. J Surg Educ. 2022;79(1):56-68. DOI:10.1016/j.jsurg.2021.06.023

  28. Ten Cate O, Nuts and Bolts of Entrustable Professional Activities.J Grad Med Educ. 2013;5(1):157-158. doi: 10.4300/JGME-D-12-00380.1

  29. Schumacher DJ, West DC, Schwartz A, Li ST, Millstein L, GriegoEC, et al. Longitudinal Assessment of Resident PerformanceUsing Entrustable Professional Activities. JAMA Netw Open.2020;3(1):e1919316. doi:10.1001/jamanetworkopen.2019.19316

  30. Matas, A. Diseño del formato de escalas tipo Likert: un estadode la cuestión. Rev electrón. investig. educ., 2018;20(1):38-47. https://doi.org/10.24320/redie.2018.20.1.1347

  31. Ten Cate O, Scheele F. Competency-Based Postgraduate Training:Can We Bridge the Gap between Theory and ClinicalPractice? Acad Med. 2007;82(6):542-7. https://doi.org/10.1097/ACM.0b013e31805559c7

  32. Desy JR, Reed DA, Wolanskyj AP. Milestones and Millennials:A Perfect Pairing-Competency-Based Medical Educationand the Learning Preferences of Generation Y. Mayo ClinProc. 2017;92(2):243-250. DOI: 10.1016/j.mayocp.2016.10.026

  33. Goroll AH, Sirio C, Duffy FD, LeBlond RF, Alguire P, BlackwellTA, et al. Residency Review Committee for Internal Medicine.A new model for accreditation of residency programsin internal medicine. Ann Intern Med. 2004;140(11):902-9.DOI: 10.7326/0003-4819-140-11-200406010-00012




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