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Acad Med. 2018 Nov 21. doi: 10.1097/ACM.0000000000002535. [Epub ahead of print]

Crossing the Gap: Using Competency-Based Assessment to Determine Whether Learners Are Ready for the Undergraduate-to-Graduate Transition.

Author information

1
K.E. Murray is assistant professor of pediatrics and director of pediatric medical student education, University of Minnesota, Minneapolis, Minnesota. J.L. Lane is retired professor of pediatrics and vice chair of education, University of Colorado, Denver, Colorado. C. Carraccio is vice president for competency-based assessment programs, American Board of Pediatrics, Chapel Hill, North Carolina. T. Glasgow is clinical professor of pediatrics, University of Utah, Salt Lake City, Utah. M. Long is associate professor of pediatrics, University of California, San Francisco, San Francisco, California. D.C. West is professor of pediatrics and vice-chair for education in the department of pediatrics, University of California, San Francisco, San Francisco, California. M. O'Connor is assistant professor of pediatrics, University of Utah, Salt Lake City, Utah. P. Hobday is assistant professor of pediatrics and Education in Pediatrics Across the Continuum (EPAC) course director, University of Minnesota, Minneapolis, Minnesota. A. Schwartz is Michael Reese Endowed Professor of Medical Education and research professor of pediatrics, University of Illinois, Chicago, Illinois. R. Englander is professor of pediatrics and associate dean for undergraduate medicaleducation, University of Minnesota, Minneapolis, Minnesota.

Abstract

In 2011, the Education in Pediatrics Across the Continuum (EPAC) Study Group recruited four medical schools (University of California, San Francisco, University of Colorado, University of Minnesota, and University of Utah) and their associated pediatrics clerkship and residency programs directors to be part of a consortium to pilot a model designed to advance learners from undergraduate medical education (UME) to graduate medical education (GME) and then to fellowship or practice based on competence rather than time spent in training. The central design features of this pilot included predetermined expectations of performance and transition criteria to ensure readiness to progress from UME to GME, using the Core Entrustable Professional Activities for Entering Residency (Core EPAs) as a common assessment framework. Using this framework, each site team (which included, but was not limited to, the EPAC course, pediatric clerkship, and pediatric residency program directors) monitored learners' progress, with the site's clinical competency committee marking the point of readiness to transition from UME to GME (i.e., the attainment of supervision level 3a). Two of the sites implemented time-variable transition from UME to GME, based on when a learner met the performance expectations and transition criteria. In this Article, the authors describe each of the four sites' implementation of Core EPA assessment and their approach to gathering the data necessary to determine readiness for transition. They conclude by offering recommendations and lessons learned from the pilot's first 7 years of development, adaptation, and implementation of assessment strategies across the sites, and discussing next steps.

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