scholarly journals Appraisal of the entrustable professional activities (EPAs) patient care provider domain by North Dakota pharmacists

2019 ◽  
Vol 17 (4) ◽  
pp. 1607
Author(s):  
David M. Scott ◽  
Michael P. Kelsch ◽  
Macey Hanel ◽  
Daniel L. Friesner
Author(s):  
Alicia Lichvar ◽  
Mary Moss Chandran ◽  
Vincent Do ◽  
Trisann Rendulic ◽  
Amanda Szczepanik ◽  
...  

Abstract Disclaimer In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The role of a solid organ transplant pharmacist is multifaceted and translates to diverse experiential and elective learning experiences that can be provided to pharmacy learners. Here we provide a guide to integrating pharmacy students into patient care and other pharmacist activities in solid organ transplantation. Summary Thoughtful incorporation of learners into clinical practice and clinical research creates a positive learning environment for pharmacy students that can foster the development of core skills necessary for students to become “practice-ready” and “team-ready” pharmacy graduates and can equip them with valuable skills to incorporate into the specialty practice areas and careers they pursue. To help develop these educational experiences, attention to the list of core entrustable professional activities (EPAs) established by the American Association of Colleges of Pharmacy can help create a rich environment of learning with carefully cultivated tasks. Furthermore, learners can serve as transplant pharmacist extenders to assist in overall patient care and multidisciplinary involvement on the transplant team. This article serves as a “how-to” guide for applying the EPA framework to integrating pharmacy students in patient care and other pharmacist activities in solid organ transplantation and other specialty practice areas. Conclusion As pharmacy preceptors design and operationalize their teaching to incorporate EPAs, they can benefit from recommendations tailored to specialty practice areas such as solid organ transplantation. Students may start and finish these experiences at different EPA levels, but continuance of training will allow them to achieve the final EPA level across the 6 EPA domains.


2020 ◽  
Vol 18 (3) ◽  
pp. 1980
Author(s):  
David M. Scott ◽  
Michael E. Kelsch ◽  
Anqing Zhang ◽  
Daniel L. Friesner

Objective.  Entrustable Professional Activities (EPAs) are a list of professional tasks (with associated competency ratings) that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy. This manuscript assesses the perceived frequency of performing EPAs in the population health promoter (PHP) domain among pharmacists practicing in North Dakota. Methods.  This survey assessed the self-reported EPA activities (inclusive of the PHP domain) of registered pharmacists living and practicing in North Dakota. There were 990 pharmacists surveyed, and 457 (46.1%) of pharmacists responded. Results. Within the PHP domain, pharmacists reported performing “Minimize adverse drug events and medication errors” most frequently (mean=3.4, SD=2.0), followed by “Ensure that patients have been immunized against vaccine-preventable diseases” (mean=2.3, SD 2.3), “Maximize the appropriate use of medications in a population” (mean=2.2, SD 2.3), and “Identify patients at risk for prevalent diseases in a population” (mean=1.3, SD=1.9). In these Core EPAs PHP domains, the clinical pharmacists reported the highest level, followed by pharmacy managers and staff pharmacists. Conclusion. Pharmacists in North Dakota reported that EPAs in the PHP domain are practiced regularly. Thus, EPAs in the PHP domain have potential as a means to assess outcomes in pharmacy education and practice.  


2021 ◽  
Vol 19 (1) ◽  
pp. 2179
Author(s):  
David M. Scott ◽  
Michael P. Kelsch ◽  
Anqing Zhang ◽  
Daniel L. Friesner

Objective: To quantify the use of the interprofessional team member (ITM) domain of entrustable professional activities (EPAs) by North Dakota pharmacists across practice sites, roles in practice, and by preceptor status. Methods: Survey methods were used to characterize the self-reported frequency with which pharmacists undertake core EPAs and supporting tasks in the ITM domain. The survey was administered to registered pharmacists practicing in North Dakota (n=990) during the fall of 2018, of which 457 (46.1%) responded. After eliminating responses with incomplete or missing information, 119 responses were available for analysis. Results: For the overall EPA ITM domain, “Collaborate as a member of an interprofessional team population” pharmacists reported performing these activities an average (mean) of 3.3 times per month (SD=2.3). Within this domain, the highest reported example activity was “Use setting appropriate communication skills when interacting with others” (mean=4.1, SD 1.8), followed by “Communicate a patient’s medication-related problem(s) to another health professional” (mean=3.3, SD 2.0), and “Contribute medication-related expertise to the team’s work” (mean=3.1, SD=2.2). ITM domain and supporting example activities were performed at a greater rate in hospitals, community health centers and long-term-care facilities. For most items, preceptors reported a greater use of activities, than did non-preceptors. Conclusions: North Dakota pharmacists currently complete tasks outlined in the ITM domain of the EPAs, although their contributions are varied by task, role, and preceptor status.


2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Tarika Srinivasan ◽  
Erica J. Sutton ◽  
Annika T. Beck ◽  
Idali Cuellar ◽  
Valentina Hernandez ◽  
...  

Introduction: Minority communities have had limited access to advances in genomic medicine. Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, partnered to assess the feasibility of offering genomic screening to Latino patients receiving care at a community-based health center. We examined primary care provider (PCP) experiences reporting genomic screening results and integrating those results into patient care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other members of the health care team charged with supporting patients who received positive genomic screening results. Interviews were recorded, transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results indicating a genetic variant that warranted clinical management. PCPs felt genomic screening was valuable to patients and their families, and that genomic research should strive to include underrepresented minorities. Providers identified multiple challenges integrating genomic sequencing into patient care, including difficulties maintaining patient contact over time; arranging follow-up medical care; and managing results in an environment with limited genetics expertise. Providers also reflected on the ethics of offering genomic sequencing to patients who may not be able to pursue diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing advances in precision medicine to community-based health centers serving under-resourced populations. By proactively considering patient support needs, and identifying financial assistance programs and patient-referral mechanisms to support patients who may need specialized medical care, PCPs and other health care providers can help to ensure that precision medicine lives up to its full potential as a tool for improving patient care.


2021 ◽  
Vol 61 (3) ◽  
pp. 702-703
Author(s):  
Kashelle Lockman ◽  
Maria Lowry ◽  
Sandra Discala ◽  
Tanya Uritsky ◽  
Amanda Lovell ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Severin Pinilla ◽  
Alexandra Kyrou ◽  
Stefan Klöppel ◽  
Werner Strik ◽  
Christoph Nissen ◽  
...  

Abstract Background Entrustable professional activities (EPAs) in competency-based, undergraduate medical education (UME) have led to new formative workplace-based assessments (WBA) using entrustment-supervision scales in clerkships. We conducted an observational, prospective cohort study to explore the usefulness of a WBA designed to assess core EPAs in a psychiatry clerkship. Methods We analyzed changes in self-entrustment ratings of students and the supervisors’ ratings per EPA. Timing and frequencies of learner-initiated WBAs based on a prospective entrustment-supervision scale and resultant narrative feedback were analyzed quantitatively and qualitatively. Predictors for indirect supervision levels were explored via regression analysis, and narrative feedback was coded using thematic content analysis. Students evaluated the WBA after each clerkship rotation. Results EPA 1 (“Take a patient’s history”), EPA 2 (“Assess physical & mental status”) and EPA 8 (“Document & present a clinical encounter”) were most frequently used for learner-initiated WBAs throughout the clerkship rotations in a sample of 83 students. Clinical residents signed off on the majority of the WBAs (71%). EPAs 1, 2, and 8 showed the largest increases in self-entrustment and received most of the indirect supervision level ratings. We found a moderate, positive correlation between self-entrusted supervision levels at the end of the clerkship and the number of documented entrustment-supervision ratings per EPA (p < 0.0001). The number of entrustment ratings explained 6.5% of the variance in the supervisors’ ratings for EPA 1. Narrative feedback was documented for 79% (n = 214) of the WBAs. Most narratives addressed the Medical Expert role (77%, n = 208) and used reinforcement (59%, n = 161) as a feedback strategy. Students perceived the feedback as beneficial. Conclusions Using formative WBAs with an entrustment-supervision scale and prompts for written feedback facilitated targeted, high-quality feedback and effectively supported students’ development toward self-entrusted, indirect supervision levels.


2021 ◽  
Vol 8 ◽  
pp. 237428952199082
Author(s):  
Kristie White ◽  
Julianne Qualtieri ◽  
Elizabeth L. Courville ◽  
Rose C. Beck ◽  
Bachir Alobeid ◽  
...  

Hematopathology fellowship education has grown in complexity as patient-centered treatment plans have come to depend on integration of clinical, morphologic, immunophenotypic, molecular, and cytogenetic variables. This complexity is in competition with the need for timely hematopathology care with stewardship of patient, laboratory, and societal resources. Accreditation Council for Graduate Medical Education Milestones provide a guidance document for hematopathology training, but fellows and their educators are in need of a simple framework that allows assessment and feedback of growth toward independent hematopathology practice. Entrustable professional activities provide one such framework, and herein, we provide proposed Hematopathology Fellowship Entrustable Professional Activities based on review of pertinent guidelines and literature, with multiple rounds of expert and stakeholder input utilizing a modified mini-Delphi approach. Ten core entrustable professional activities deemed essential for graduating hematopathology fellows were developed together with skills and knowledge statements, example scenarios, and corresponding Accreditation Council for Graduate Medical Education Milestones. Application of these entrustable professional activities in program design, fellow evaluation, and decisions regarding level of supervision is discussed with consideration of benefits and barriers to implementation. These entrustable professional activities may be used by hematopathology fellowship directors and faculty to provide fellows with timely constructive feedback, determine entrustment decisions, provide the Clinical Competency Committee with granular data to support Milestone evaluations, and provide insight into areas of potential improvement in fellowship training. Fellows will benefit from a clear roadmap to independent hematopathology practice with concrete and timely feedback.


Author(s):  
Daniel J. Schumacher ◽  
Abigail Martini ◽  
Benjamin Kinnear ◽  
Matthew Kelleher ◽  
Dorene F. Balmer ◽  
...  

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