E1162. Identifying Undergraduate-Level, Radiology-Specific Entrustable Professional Activities
  1. Ryan Smith; Dalhousie University; Memorial University of Newfoundland
  2. Angus Hartery; Memorial University of Newfoundland
  3. Wes Chan; Memorial University of Newfoundland
  4. Nic Fairbridge; Memorial University of Newfoundland
  5. Katrin Zipperlen; Memorial University of Newfoundland
Over the last decade, a shift in assessment technique has occurred toward evaluating medical trainees based on entrustable professional activities (EPAs) as opposed to general competencies. At our institution, The Association of Faculties of Medicine of Canada’s (AFMC) EPA list for every Canadian medical school graduate has been adopted as the basis of assessment for clerkship students. Based on faculty and student informal feedback, this list is not well suited to electives in diagnostic radiology where traditional direct patient interaction is not the core of the specialty. In the literature, specialty-specific EPAs have proven to be beneficial to elective students by helping guide their learning, improve their attainment of clinical competence, and better prepare them to begin residency. The purpose of this quality improvement initiative was to compile a set of undergraduate, radiology-specific EPAs that could be used to assess students rotating through diagnostic radiology.

Materials and Methods:
We identified potential undergraduate, radiology-specific EPAs via a literature review and a modified Delphi survey. The Delphi method is a flexible technique that uses an iterative approach to poll experts on a topic. We identified experts on undergraduate radiology EPA creation via targeted email correspondence to radiology departments at medical schools across Canada. Participants were initially asked to qualitatively offer potential EPAs. The results of this initial survey were amalgamated with the literature review to generate a list of EPAs, which was then recirculated to experts for commenting and scoring for appropriateness. EPAs that reached consensus among experts (>80% agreed they were appropriate) were further developed according to framework of the AFMC and our institution in preparation for future implementation.

The literature review identified one article from a foreign institution with a similar endeavor to ours that included six potential EPAs. Our initial survey was completed by 14 experts who suggested 56 potential EPAs. Results of the literature review and initial survey were amalgamated into 14 overarching potential EPAs. Six experts participated in the scoring of these EPAs, with seven EPAs achieving expert consensus. One additional EPA with borderline appropriateness was also developed further based on its emphasis by initial survey respondents, comments from scorers in the second survey, and local support of appropriateness.

Altogether, our work identified a set of eight expert-supported, undergraduate, radiology-specific EPAs that will soon be implemented at our institution for elective students (review of their impact to follow). Limitations to our work include a low number of participating experts in the scoring of potential EPAs which prevented us from doing multiple iterations of scoring. Ideally, more interactions with experts would create a chance for further explanation and discussion and allow the option of rewording, expanding, and/or downscaling potential EPAs to ultimately be deemed appropriate by consensus.