Evidence-based Fluency for Medical Schools: Entrustable Professional Activities and Milestones

Creating medical information literacy entrustable professional activities (EPAs) and milestones

 
This project will define what is meant in various medical school competencies by "evidence-based application of medical knowledge". It will also provide the structure for both enhancing and integrating these concepts into our respective medical schools' curricula [1] by creating EPAs [2] and milestones [3]. This work will be written with contributions from multiple perspectives and published in a scholalry journal.

Although ACGME and LCME set expectations for using evidence competently, no defining document(s) exist(s) at the local or national level detailing exactly what that entails, and what faculty and students should be expected to do at various levels in their program. Unless and until these concepts are described and broken into component parts, they cannot be taught and are unlikely to be mastered. This work is necessary as these competencies underscore patient-care, discovery and the physician's continuously developing knowledge base. As such they deserve and require further articulation. Medical school librarians and medical faculty need to describe specifically what the EPAs involving meta-literacies and evidence are and how and when those concepts will be taught (milestones).

Research and Learning Librarians at the University of Kansas Medical Center have mapped the new Association of College and Research Libraries' (ACRL) Framework for Information Literacy for Higher Education [5] to ACGME, LCME, and local program competencies in an effort to begin planning this work. Additionally, sample milestone and EPA documents have been created. A review of the literature and poll of several medical school librarians across multiple regions uncovered a gap in this area. Individuals and professional associations are calling for this work. KUMC's efforts are the first to emerge.

Project deliverables will include:

• EPAs and milestone documents usable in medical school curricula
• A cross-referenced map of existing ACGME, AAMC, ACRL, LCME and local competencies will be help focus the work on enhancing existing content
• A scholalry publication
• Creation of a departmental and inter-institutional working group
• Curricular and extra-curricular content focused on new EPAs & milestones

References

1. Signature Pedagogy | The Carnegie Project on the Education Doctorate [Internet]. [cited 2015 Sep 23].
Available from: http://perryjil.pairserver.com/signature-pedagogy#sthash.Uw9Nh6Sy.dpuf

2. Ten Cate, Olle. Nuts and Bolts of Entrustable Professional Activities. J Grad Med Educ. 2013 Mar;5(1):157–8.

3. Hicks PJ, Englander R, Schumacher DJ, Burke A, Benson BJ, Guralnick S, et al. Pediatrics milestone project: next steps toward meaningful outcomes assessment.
J Grad Med Educ. 2010 Dec;2(4):577–84.

4. ACGME > Program and Institutional Accreditation > Next Accreditation System > Milestones [Internet]. [cited 2015 Sep 23]. Available from:     
https://www.acgme.org/acgmeweb/tabid/430/ProgramandInstitutionalAccreditation/NextAccreditationSystem/Milestones.aspx

5. Framework for Information Literacy for Higher Education | Association of College & Research Libraries (ACRL) [Internet]. [cited 2015 Sep 23].
Available from: http://www.ala.org/acrl/standards/ilframework