Echocardiography curriculum development for physician assistants using entrustable professional activities

BACKGROUND: With the projected increase of cardiovascular disease in the aging population, a higher demand for echocardiography use is predicted. However, there is a shortage in the supply of cardiologists, to the point that a 2009 American College of Cardiology survey report called it a "cardiology workforce crisis". The report also recommends a more aggressive use of PAs and NPs as one of the solutions to fill the shortage. Currently, echocardiography is not routinely included in the scope of practice for PAs in cardiology. While PAs attain strong basic science knowledge and clinical training experience in PA school, they typically do not receive additional formal postgraduate training. PAs have limited training opportunities to train in echocardiography and receive certification of recognition, but a formally standardized training program and certifying examination geared specifically for PAs are yet to be developed. This study seeks to develop a pilot curriculum in training echocardiography which can be standardized for utilization across various regions and medical subspecialties. The curriculum draws on the concept of Entrustable Professional Activities (EPA), which is being actively used in graduate medical education. HYPOTHESIS: After participating in the proposed pilot curriculum which involves online didactic learning and supervised hands-on clinical training, trained PAs will be able to reach proficiency in echocardiography operation and interpretation at level 4 supervision according to the EPA guidelines. METHODS: This study proposes a pilot curriculum with framework based on the EPA titled “performing and interpreting echocardiography” by PAs. The curriculum involves didactic and clinical training in echocardiography, with the goal to achieve mastery of level 4 supervision (minimal supervision). 2 subjects will be recruited from a teaching medical institution in the Greater Boston area with an IAC accredited echocardiography laboratory. After the 12-month training, participants will take ASCeXAM/ReASCE Online Practice Exam Simulation offered by the ASE. Upon 1) achievement of individualized EPAs as assessed by supervisor, and 2) simulation exam score of >80%, participants will earn a STAR in echocardiography. CONCLUSION: The study is the first step to establishing an effective training curriculum that will eventually be a basis for creating a certifying exam in echocardiography, designed specifically for PAs. As this study merely suggests a new curriculum, future studies should focus on identifying strengths and weaknesses of the curriculum after implementation and expansion to multiple sites, and gather data to use for continual improvement of the training curriculum

New Dimensions of Education Reform in the Republic of Moldova: Equity, Relevance, Efficiency and Sustainability

Economic and social development of any country is determined by its intellectual potential, built up mainly in the education system. Despite of various reforms and reorganizations the education system in the Republic of Moldova has experienced during the last two decades, it has not yet become an efficient and decisive factor of the progress on all dimensions that call for a modern development of the country in a competitive global environment. For these reasons, it has become imperative that national education modernizes and adjusts to the international educational requirements. The reform ought to be based on an integrative and systemic approach, focused on quality and performance, competitiveness and relevance, autonomy and accountability, transparency and participatory management in education. This paper briefly sets forth the vision upon the key issues of national education modernization, which in future will be the basis for qualitative reform processes of the field.education; modernization of national education; educational performances; quality assurance of education; education law.

Education in Family Medicine : What has been achieved?

Contents: Education... historical landmarks - Pierre Mallia; The Malta College of Family Doctors and the Royal College of General Practitioners - John V. Howard; The MRCGP [INT] Qualification and Programme - Adrian Freeman; Malta from the view of an External Development Advisor - Jeremy Stupple; The Specialist Training Programme in Family Medicine - Malta - Mario R. Sammut and Gunther Abela; Psychometrics – MCFD/MRCGP[INT] summative examination - Dominic Agius; Continued professional development - Philip Sciortino; The Diploma in Family Practice in retrospect - Pierre Mallia; Report on MCFD Assessment Course - Renzo De GabrieleThe mission of the Journal of the Malta College of Family Doctors (JMCFD) is to deliver accurate, relevant and inspiring research, continued medical education and debate in family medicine with the aim of encouraging improved patient care through academic development of the discipline. As the main official publication of the Malta College of Family Doctors, the JMCFD strives to achieve its role to disseminate information on the objectives and activities of the College.peer-reviewe

Adding value to laboratory medicine: a professional responsibility

Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to ‘add value’ to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic ‘SCIENCE’. This tool allows added value to be considered in seven domains: standardisation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine