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Original research
Development of entrustable professional activities for regional anesthesia and pain medicine fellowship training
  1. Steven Porter1,
  2. Elaine Prendiville2,
  3. Brian Frazer Scott Allen3,
  4. Gregory Booth4,
  5. Jan Boublik5,
  6. Garrett W Burnett6,
  7. Nabil Elkassabany7,
  8. Jonathan Hausman8,
  9. Lisa Klesius9,
  10. Linda Le-Wendling10,
  11. Anthony T Machi11,
  12. Robert Maniker12,13,
  13. Michelle Parra14,
  14. Richard Rosenquist15,
  15. Christina M Spofford16,
  16. Santhanam Suresh17,
  17. Tiffany Tedore18,
  18. Elizabeth H Wilson19,
  19. Jon Yan Zhou20 and
  20. Glenn Woodworth2
  1. 1 Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA
  2. 2 Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA
  3. 3 Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  4. 4 Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth Department of Anesthesiology and Pain Medicine, Portsmouth, Virginia, USA
  5. 5 Anesthesiology, Stanford Hospital and Clinics, Stanford, California, USA
  6. 6 Anesthesiology, Perioperative & Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  7. 7 Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
  8. 8 Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
  9. 9 Department of Anesthesiology, University of Wisconsin System, Madison, Wisconsin, USA
  10. 10 Anesthesiology, University of Florida, Gainesville, Florida, USA
  11. 11 Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  12. 12 Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, USA
  13. 13 Department of Anesthesiology, Columbia University Medical Center, New York, New York, USA
  14. 14 Anesthesia, University of Iowa, Iowa City, Iowa, USA
  15. 15 Pain Management, Cleveland Clinic, Cleveland, Ohio, USA
  16. 16 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  17. 17 Pediatric Anesthesiology, Northwestern Medicine, Chicago, Illinois, USA
  18. 18 Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
  19. 19 Department of Anesthesiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
  20. 20 Anesthesiology and Pain Medicine, University of California Davis Health System, Sacramento, California, USA
  1. Correspondence to Dr Glenn Woodworth, Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA; woodworg{at}ohsu.edu

Abstract

Introduction The Accreditation Council for Graduate Medical Education (ACGME) offers descriptions of competencies and milestones but does not provide standardized assessments to track trainee competency. Entrustable professional activities (EPAs) and special assessments (SAs) are emerging methods to assess the level of competency obtained by regional anesthesiology and acute pain medicine (RAAPM) fellows.

Methods A panel of RAAPM physicians with experience in education and competency assessment and one medical student were recruited to participate in a modified Delphi method with iterative rounds to reach consensus on: a list of EPAs, SAs, and procedural skills; detailed definitions for each EPA and SA; a mapping of the EPAs and SAs to the ACGME milestones; and a target level of entrustment for graduating US RAAPM fellows for each EPA and procedural skill. A gap analysis was performed and a heat map was created to cross-check the EPAs and SAs to the ACGME milestones.

Results Participants in EPA and SA development included 19 physicians and 1 medical student from 18 different programs. The Delphi rounds yielded a final list of 23 EPAs, a defined entrustment scale, mapping of the EPAs to ACGME milestones, and graduation targets. A list of 73 procedural skills and 7 SAs were similarly developed.

Discussion A list of 23 RAAPM EPAs, 73 procedural skills, and 7 SAs were created using a rigorous methodology to reach consensus. This framework can be utilized to help assess RAAPM fellows in the USA for competency and allow for meaningful performance feedback.

  • education
  • regional anesthesia
  • acute pain

Data availability statement

Data are available upon reasonable request. There is no data to report on this study, except for the individually mapped/defined entrustable professional activities and special assessments, which are available upon request.

https://doi.org/10.1136/rapm-2022-103854

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    Data availability statement

    Data are available upon reasonable request. There is no data to report on this study, except for the individually mapped/defined entrustable professional activities and special assessments, which are available upon request.

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    Footnotes

    • SP and EP are joint first authors.

    • Twitter @janboublik MDPhD, @acutepainjz

    • Contributors Guarantor: GW. SP: Conception and design of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article, final approval of the version to be published. EP: Conception and design of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article, final approval of the version to be published. BFSA: Conception and design of the work, data analysis and interpretation, reviewing and editing of the article, final approval of the version to be published. GB: Conception and design of the work, data analysis and interpretation, reviewing and editing of the article, final approval of the version to be published. JB: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. GWB: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. NE: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. JH: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. LK: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. LL-W: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. ATM: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. RM: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. MP: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. RR: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. CMS: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. SS: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. TT: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. EHW: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. JYZ: Conception and design of the work, data analysis and interpretation, final approval of the version to be published. GW: Conception and design of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article, final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.