Projects
A Unified System of Assessment and Predictive Learning Analytics Utilizing Entrustable Professional Activities Across Emergency Medicine Residency Programs
Medical education is moving toward a competency-based system, but there is a significant gap between medical school and residency training.
Our goal is to develop specific, measurable outcomes of tiered entrustable professional activities (EPAs) to optimize the transition from medical school to residency and throughout emergency medicine training. Research includes:
A multi-site pilot study of six diverse emergency medicine residency programs.
Draft and authenticate tiered EPAs for entering interns, junior residents, senior residents, and those transitioning to independent practice. These will be supported by granular observable practice activities (OPAs).
Develop, pilot, and implement a learning analytics dashboard that integrates multi-modal assessment data for EPAs and OPAs.
Provide the infrastructure for development of individualized learning plans, clinical competency committee summative decision-making processes, and predictive analytics curves.
EXPECTED OUTCOMES
Predictive analytics curves for early identification of areas for improvement and concrete targets for individualization of learning.
A model for specialty residency programs to align medical education assessment and individualize residency training in a competency-based framework.
Transformation of competency-based assessment across all ACGME-accredited Emergency Medicine training programs.
This project is funded by the American Medical Association
Assessing residents’ independent and interdependent clinical performance using electronic health records
A key premise of Competency-Based Medical Education (CBME) is the ability to assess independent resident performance. However, in clinical settings, outcomes can be difficult to link to an individual as performance is often interdependent with others, particularly faculty supervisors.
Our study investigates how data collected in the electronic health record (HER) might be used to assess residents’ independent and interdependent clinical performance.
The EHR is currently an untapped source of data that could be used to explore aspects of independent and interdependent clinical performance. However, a key assumption with EHR data is that a specific data point can be attributed to an individual physician’s performance. This assumption might not hold true for residents.
EXPECTED OUTCOMES
A list of clinical performance indicators for Emergency Medicine that reflect both independent or interdependent resident performance
A prototype resident report card consisting of several independent and interdependent performance indicators extracted from the EHR
A documented description of the social process surrounding the use of resident report cards as a foundation for feedback discussions between faculty and residents
This project was funded by the Royal College of Physicians and Surgeons of Canada
Development of a Simulation Curriculum and Web-Based Modules to Teach and Assess Core EPA 10 to Medical Students
Timeline: 2020-2022
In 2013, the Association of American Medical Colleges (AAMC) created thirteen Core Entrustable Professional Activities (EPAs) for Entering Residency to define a common core set of behaviors expected of all medical students graduating from medical school.1 EPA Ten outlines an objective for graduating medical students to: “recognize a patient requiring urgent or emergent care and initiate evaluation and management.”1 EPA Ten has been rated as the fourth most essential EPA for medical students to be able to perform on the first day of intern year, behind gathering a history and performing a physical exam, providing an oral presentation and summarizing a patient encounter, and developing a prioritized differential diagnosis. Given the rarity of opportunities for medical students to primarily encounter and manage emergencies, and the difficulty in assessing this skill in the clinical setting, there is a need for additional educational opportunities to prepare medical students for this role prior to internship.
Research Aim 1: Validate the list of specific emergent conditions under EPA Ten that a medical student should be expected to manage upon graduating, as outlined by the AAMC and CDEM. This will be achieved through expert consensus utilizing a modified Delphi approach.
Research Aim 2: Based upon the findings of the survey of experts, develop two simulation-based cases on recognizing and initiating care for critically ill patients, in order to develop a universal assessment checklist for these simulation cases to ensure learning and to provide supplemental data to inform summative entrustment decisions; these cases and tools can be shared across medical schools and with residency programs as part of the post-Match learner handover process.
Research Aim 3: Based upon the findings in the survey of experts, develop two asynchronous online instructional modules on managing emergent conditions that can be shared across medical schools to teach the requisite skills in EPA Ten.
Research Aim 4: Perform a prospective observational study of fourth year medical students enrolled in an EM clerkship at an academic urban medical center and evaluate if the educational intervention of simulation-based cases and instructional modules improves medical student performance in recognizing and initiating care in critically ill patients within the Emergency Department.
This project is funded by the Society of Academic Emergency Medicine Foundation
Simulation Based Mastery Learning to Teach Distal Radius Fracture Reduction
Project Goals:
Develop a simulation based mastery learning curriculum to teach distal radius fracture reduction to emergency medicine and orthopedic surgery interns
Develop curriculum and SBML course; measure improvement and competence
This project was funded by TMA
