Background: The introduction of a 2-year postgraduate year (PGY) training program for general medicine in Taiwan in 2019 necessitated the development of appropriate competency-based assessment tools. The Entrustable Professional Activities (EPAs) framework established by the Association of American Medical Colleges (AAMC) presents a structured approach to evaluating clinical competencies.

Objective: This study aimed to contextualize the 13 Core EPAs proposed by the AAMC and construct an EPA-based assessment framework tailored to the Taiwanese PGY program.

Methods: Employing the nominal group technique, a multidisciplinary panel comprising 13 clinical faculty members, 8 resident physicians, and 13 PGY trainees engaged in discussions to reach a consensus on the essential professional tasks encompassing the medical student to PGY trainee continuum. After reviewing the AAMC's EPAs, 34 experts ranked the identified tasks based on importance through voting and scoring on a 5-point scale. Subsequently, real-time EPA assessment forms were developed and validated during objective structured clinical examinations (OSCEs) for PGY trainees.

Results: A consensus was reached on 42 EPA themes, categorized into seven major domains: receiving new patients, interpreting and managing examination reports, handling common complaints, identifying and managing critical patients, preparing for ward rounds, explaining general medical conditions and obtaining consent, and performing general procedural skills. Specific task descriptions, evaluation criteria, and assessment forms were created for each EPA.

Significance: This study contextualized the AAMC's EPA framework to the Taiwanese healthcare setting, providing a competency-based assessment structure tailored to the PGY program. The developed EPA-based assessment tools can inform curriculum design and facilitate the evaluation of trainees' clinical competencies, ultimately enhancing the quality of post-graduate medical education in Taiwan.

Authors:
Hsu Chihming, Chiayi Chang Gung Memorial Hospital, Taiwan

About the Presenter(s)
Dr. Hsu Chihming is currently a director of the Medical Education Department at Chiayi Chang Gung Memorial Hospital. The main research areas are medical education, curriculum development and the development of innovative assessment methods.

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