Academic medicine : journal of the Association of American Medical Colleges
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Assessing entrustable professional activities (EPAs), or carefully chosen units of work that define a profession and are entrusted to a resident to complete unsupervised once she or he has obtained adequate competence, is a novel and innovative approach to competency-based assessment (CBA). What is currently not well described in the literature is the application of EPAs within a CBA system. In this article, the authors describe the development of 35 EPAs for a Canadian family medicine residency program, including the work by an expert panel of family physician and medical education experts from four universities in three Canadian provinces to identify the relevant EPAs for family medicine in nine curriculum domains. ⋯ They then describe the system to compile, collate, and use the EPA field notes to make competency declarations and how this system aligns with van der Vleuten's utility index for assessment (valid, reliable, of educational value, acceptable, cost-effective). Early outcomes indicate that preceptors are using the EPA field notes more often than they used the generic field notes. EPAs enable educators to evaluate multiple objectives and important but unwieldy competencies by providing practical, manageable, measurable activities that can be used to assess competency development.
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The United States spends $2.7 trillion a year on health care, more than any other country by far, and yet the U. S. population is not healthy. In fact, the United States loses $227 billion in productivity each year because of poor health. ⋯ This Commentary explores the principles behind the Culture of Health initiative and examines the role of academic medicine in achieving this vision. Different communities must come up with the approaches that serve them best. Only by working toward a common goal in unique ways will a true Culture of Health be attainable in the United States.
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To determine the number of DO (doctor of osteopathic medicine) and MD (doctor of medicine) residents in training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) and to examine the behavior of DO residents who moved between the two types of programs. ⋯ These data provide the first comprehensive accounting of the numbers of individuals in U.S. GME, in both ACGME- and AOA-accredited residencies. The number of graduates from U.S. medical schools is increasing rapidly; residency positions are growing more slowly. The planned unified accreditation of U.S. GME may cause significant changes in the patterns of GME for future trainees.