Entrustable professional activities (EPAs) have become a popular topic within competency-based medical education programs in many countries and hundreds of publications within only a few years. This paper was written to introduce the ins and outs of EPAs. After a brief historical overview, the rational of EPAs, as a bridge between a competency framework and daily clinical practice, is explained. Next, entrustment decision-making as a form of assessment is elaborated and framework of levels of supervision is presented. For readers interested to apply the concept in practice a stepwise approach to curriculum development is proposed. The paper concludes with an overview of the state of the art of working with EPAs in across disciplines, professions and countries.
Curriculum ; Education, Medical ; Organization and Administration

Academic Medical Centers ; organization & administration ; Biomedical Research ; organization & administration ; Education, Medical ; organization & administration ; Faculty, Medical ; Humans ; Singapore

COVID-19/transmission* ; Communicable Disease Control/organization & administration* ; Education, Distance/organization & administration* ; Education, Medical/organization & administration* ; Humans ; Otolaryngology/organization & administration* ; Singapore/epidemiology* ; Telemedicine/organization & administration*

Clinical Clerkship ; Education, Medical ; organization & administration ; standards ; Singapore

INTRODUCTIONThe Academic Medicine Education Institute (AM∙EI), jointly established by Duke-NUS Graduate Medical School (Duke-NUS) and Singapore Healthcare Services (SingHealth), is a newly formed health professions education academy designed to cultivate best education practices and create a community of health professions educators. To achieve the aims of AM∙EI, the needs of SingHealth educators have to be understood. Therefore, this study was carried out to assess educators' perceptions towards the current education climate and their academic needs.

MATERIALS AND METHODSA 28-item questionnaire consisting of free-response, Likert-type and ranking questions was developed. The questionnaire was electronically distributed to 200 medical and nursing educators, and made available to attendees of the 2012 Singhealth Duke-NUS Scientific Congress through hardcopies.

RESULTSA total of 150 completed questionnaires were received (94 from electronic survey and 56 from Congress). Five themes emerged from the analysis of responses to free-response questions: 1) faculty development, 2) development of a community of educators, 3) recognition for educational efforts, 4) institutional support, and 5) better communication about SingHealth educational activities. Respondents were in highest agreement with the statements (rating of 3.7 out of 5): "The SingHealth education programmes are high quality", "New learning or teaching methods are welcomed in this institution/hospital", and "An academic appointment is important to me". The competencies that respondents felt to be the most important were facilitating discussions, presentation skills, and providing feedback (respective means = 5.1, 5, 5 of 7).

CONCLUSIONThis needs assessment provided us with important insights regarding SingHealth medical educators' perceptions of their education environment and established key priorities for the AM∙EI's programming efforts.

Academies and Institutes ; Attitude of Health Personnel ; Education, Medical ; organization & administration ; Education, Nursing ; organization & administration ; Faculty, Medical ; organization & administration ; Faculty, Nursing ; organization & administration ; Humans ; International Cooperation ; Needs Assessment ; North Carolina ; Organizational Culture ; Schools, Medical ; organization & administration ; Singapore ; Surveys and Questionnaires

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.
Education, Medical, Undergraduate ; organization & administration ; standards ; Faculty, Medical ; Germany ; Humans ; Organizational Case Studies ; Organizational Innovation ; Problem-Based Learning ; organization & administration ; Schools, Medical ; organization & administration ; Total Quality Management

This article is intended to review up to date knowledge about standardized patients (SPs) and SP-based objective structured clinical examinations (OSCE) in medical education. SPs have become almost indispensable in the education and training of health care professionals. The utilization of SPs provides an invaluable contribution to the creation of a safe, yet realistic, learner-centered environment. While SPs provide a realistic experience of patient interaction that can be evaluated by a third party observer, they can also be trained to assess the student's performance and provide feedback to the student with consistency. Standardization of the performance, recording student behaviors by well-developed checklists, and/or receiving feedback from the SPs are important parameters of the educational experience and provide a meaningful evaluation of student performance. In assessment, SPs are used most commonly in the context of formal examinations, often referred to as OSCEs. An OSCE should be prepared step by step according to principles of appropriate logistics. The validity of the OSCE assessment is increased by matching educational content with the balanced blue print matrix for comprehensive performance examination. The thorough training of all physician/SP raters involved during the whole observation time in which students interact with SPs is critical to the reliable OSCE. SP-based OSCE has its own limitations, so it is to be judged as one among many evaluation methods for competency and/or performance.
Checklist ; Competency-Based Education ; Delivery of Health Care ; Education, Medical ; Humans ; Organization and Administration ; Patient Simulation

China ; Education, Medical ; organization & administration ; standards ; Periodontics ; education ; Research Design ; Surveys and Questionnaires

Constant change is inevitable in medical education. Medical education is continually influenced as medical schools adapt to new environments, as the society redefines the role of doctors, by ongoing advancements in medical practice, and as educational theory and practice continues to improve. In addition, the external stakeholders such as consumers, government, and accreditation bodies and internal stakeholders such as professors and students are seeking for changes in medical education. Developing an adequate response to the ongoing change in medical education is not easy. Making changes in a complex system like medical education has been compared to 'moving a graveyard'. In order to facilitate successful adaptation to the evolving social and educational parameters involved in medical education, leadership would benefit greatly by the study and application of change management theory that has proven successful in corporate manage ment. A number of authors have suggested that 'in loosely coupled organizations like medical schools, a campaign approach is more effective than a general change management approach'. To make the campaign approach successful, change leaders in medical education need to be facilitative leaders who can stimulate and guide constructive dialogue between faculty members and students, and who can promote a sense of ownership of the ongoing changes developing in the consultations between the internal stakeholders comprising the professors and students.
Accreditation ; Education, Medical ; Humans ; Leadership ; Organization and Administration ; Organizational Innovation ; Ownership ; Referral and Consultation ; Schools, Medical

The increasing globalisation of medicine, as manifested in the migration rate of medical doctors and in the growth of cross-border education providers, has inflicted a wave of quality assurance efforts in medical education, and underlined the need for definition of standards and for introduction of effective and transparent accreditation systems. In 2004, reflecting the importance of the interface between medical education and the healthcare delivery sector, a World Health Organization (WHO)/World Federation for Medical Education (WFME) Strategic Partnership to improve medical education was formed. In 2005, the partnership published Guidelines for Accreditation of Basic Medical Education. The WHO/WFME Guidelines recommend the establishment of proper accreditation systems that are effective, independent, transparent and based on medical education-specific criteria. An important prerequisite for this development was the WFME Global Standards programme, initiated in 1997 and widely endorsed. The standards are now being used in all 6 WHO/WFME regions as a basis for quality improvement of medical education throughout its continuum and as a template for national and regional accreditation standards. Promotion of national accreditation systems will have a pivotal influence on future international appraisal of medical education. Information about accreditation status - the agencies involved and the criteria and procedure used - will be an essential component of new Global Directories of Health Professions Educational Institutions. According to an agreement between the WHO and the University of Copenhagen (UC), these Directories (the Avicenna Directories) will be developed and published by the UC with the assistance of the WFME, starting with renewal of the WHO World Directory of Medical Schools, and sequentially expanding to cover educational institutions for other health professions. The Directories will be a foundation for international meta-recognition ("accrediting the accreditors") of educational institutions and their programmes.
Accreditation ; Curriculum ; Education, Medical ; standards ; Internationality ; Policy Making ; Quality Control ; Schools, Medical ; World Health Organization