A Multistakeholder Approach to the Development of Entrustable Professional Activities in Complex Care

Kathleen Huth; Duncan Henry; Camila Cribb Fabersunne; Cara L Coleman; Brigit Frank; Daniel Schumacher; Neha Shah

doi:10.1016/j.acap.2021.09.014

A Multistakeholder Approach to the Development of Entrustable Professional Activities in Complex Care

Acad Pediatr. 2022 Mar;22(2):184-189. doi: 10.1016/j.acap.2021.09.014. Epub 2021 Sep 30.

Authors

Kathleen Huth¹, Duncan Henry², Camila Cribb Fabersunne³, Cara L Coleman⁴, Brigit Frank⁵, Daniel Schumacher⁶, Neha Shah⁷

Affiliations

¹ Department of Pediatrics, Boston Children's Hospital (K Huth), Boston, Mass; Harvard Medical School, (K Huth), Boston, Mass. Electronic address: kathleen.huth@childrens.harvard.edu.
² UCSF Pediatric Residency Program, UCSF Benioff Children's Hospital (D Henry), San Francisco, Calif; Department of Pediatrics, University of California San Francisco (D Henry), San Francisco, Ca.
³ UCSF Benioff Children's Hospital (CC Fabersunne), San Francisco, Ca; Department of Pediatrics, University of California San Francisco (CC Fabersunne).
⁴ Family Voices, Inc. (CL Coleman), Lorton, Va; Virginia Commonwealth University School of Medicine (CL Coleman), Richmond, Va.
⁵ Family Voices of Wisconsin (B Frank), Madison, Wis.
⁶ Department of Pediatrics, Cincinnati Children's Hospital Medical Center (D Schumacher), Cincinnati, Ohio.
⁷ Hospital Medicine Division, Children's National Hospital (N Shah), Washington, DC; The George Washington University, School of Medicine and Health Sciences (N Shah), Washington, DC.

PMID: 34600114
DOI: 10.1016/j.acap.2021.09.014

Abstract

Background: Care of children with medical complexity (CMC) involves unique knowledge, skills, and attitudes. Previous work has identified curricular priorities in complex care for pediatricians yet there are no established competency frameworks to guide curriculum development. We aimed to develop and appraise Entrustable Professional Activities (EPAs) for the care of CMC with multistakeholder involvement.

Methods: We recruited complex care practitioners to develop EPAs using a template for elaborating descriptive elements. A team of clinicians, educators, trainees, and family leaders refined EPAs and mapped content to the Accreditation Council for Graduate Medical Education Milestones. We conducted virtual focus groups to assess whether EPAs represented the essential skills of pediatricians caring for CMC. Focus group data were analyzed using content analysis.

Results: Content experts developed 11 EPAs for the care of CMC describing knowledge, skills, and attitudes required for attaining competency. EPAs were mapped to 21 of the 21 (100%) reporting pediatric milestones. Focus group participants endorsed and refined EPA content. Categories of feedback included clarifying medical knowledge, expanding on interpersonal communication skills, emphasizing systems-based practice, and affirming family partnership.

Conclusions: A systematic approach to developing EPAs for the care of CMC provides a guide for curriculum development and assessment in complex care.

Keywords: children with medical complexity; complex care; curriculum development; entrustable professional activities.

MeSH terms

Accreditation
Child
Clinical Competence*
Communication
Competency-Based Education
Curriculum
Education, Medical, Graduate
Humans
Internship and Residency*