• David R Taylor, Yoon Soo Park, Christopher A Smith, Jolanta Karpinski, William Coke, and Ara Tekian.
• Queen's University School of Medicine, Kingston, Ontario, Canada (D.R.T., C.A.S.).
• Ann. Intern. Med. 2018 May 15; 168 (10): 724-729.

BackgroundCompetency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work.ObjectiveTo develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, "Admit and manage a medical inpatient with a new acute problem").DesignA modified Delphi process involving clinical experts followed by a conference of educational experts.SettingThe Royal College of Physicians and Surgeons of Canada.ParticipantsIn phase 1 of the project, members of the Specialty Committee for Internal Medicine participated in a modified Delphi process to identify activities in internal medicine that represent the scope of the specialty. In phase 2 of the project, 5 experts who were scholars and leaders in competency-based medical education reviewed the results.MeasurementsPhase 1 identified important activities, revised descriptions to improve accuracy and avoid overlap, and assigned activities to stages of training. Phase 2 compared proposed activity descriptions with published guidelines for their development and application in medical education.ResultsThe project identified 29 activities that qualify as entrustable professional activities. The project also produced a detailed description of each activity and guidelines for using them to assess residents.LimitationThese activities reflect the practice patterns of the developers and may not fully represent internal medicine practice in Canada.ConclusionIdentification of these activities is expected to facilitate modification of training and assessment programs for medical residents so that programs focus less on isolated skills and more on integrated tasks.Primary Funding SourceSoutheastern Ontario Academic Medical Organization Endowed Scholarship and Education Fund and Queen's University Department of Medicine Innovation Fund.

10 keywords...

hide…