Development of an Entrustable Professional Activities (EPA) Framework to Inform Surgical Residency Training Programs in Ethiopia: A Three-round National Delphi Method Study

Amare, Equlinet Misganaw; Siebeck, Matthias; Sendekie, Tegbar Yigzaw; Fischer, Martin R. und Berndt, Markus (2021): Development of an Entrustable Professional Activities (EPA) Framework to Inform Surgical Residency Training Programs in Ethiopia: A Three-round National Delphi Method Study. In: Journal of Surgical Education, Bd. 79, Nr. 1: S. 56-68

Abstract

BACKGROUND: Entrustable Professional Activities (EPAs) have been proposed as a means to translate competencies into clinical practice. Although EPAs for residency training have become available, 1 set of core EPAs cannot automatically be transferred from one context to another due to cultural variability. Further, there is a lack of African-and Asian-based EPA development and implementation studies. We developed an end-of-training EPAs framework to inform surgical residency training programs in the local context of Ethiopian medical education. METHODS: A three-round Delphi method was used to establish consensus about important surgical EPAs among experts. A total of 136 experts representing all surgical residency training institutions in Ethiopia were invited to participate. Round 1 & 2 consisted of senior expert panelists (n = 8) to identify potential EPAs and determine the content validity. Round 3 consisted of a survey (n = 128) to further validate the identified EPAs by attending surgeons who work with them. Each EPA had to achieve at least 80% or higher agreement among experts to be considered having acceptable content validity. RESULTS: In round 1, a total of 272 EPAs were proposed, reduced, and grouped to 39 consented EPAs. In round 2, the same experts rated each EPA's relevance, resulting in 32 EPAs with a satisfactory item-level content validity index (I-CVI > 0.83). Overall, in the survey in round 3, 29 EPAs met the standard criterion for acceptability (S-CVI/Ave = 0.90) and achieved a high degree of final consensus (ICC = 0.998, 95% CI [0.996, 0.999];(F = 439.2, p < 0.0001). CONCLUSIONS: The framework of 29 validated and accepted EPAs can guide future surgical residency training programs in the Ethiopian medical education context. The framework allows programs to move from a time-dependent to an outcome-based model and transforms traditional assessment into entrustment decisions. Thus, the use of the framework can improve the quality of training and patient care in Ehtiopia. ((C) 2021 The Authors. Published by Elsevier Inc. on behalf of Association of Program Directors in Surgery.)

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1931-7204
• Sprache: Englisch