Assessment Tools for Feedback and Entrustment Decisions in the Clinical Workplace: A Systematic Review

BACKGROUND: Entrustable Professional Activities (EPAs) combine feedback and evaluation with a permission to act under a specified level of supervision and the possibility to schedule learners for clinical service. This literature review aims to identify workplace-based assessment tools that indicate progression toward unsupervised practice, suitable for entrustment decisions and feedback to learners. METHODS: A systematic search was performed in the PubMed, Embase, ERIC, and PsycINFO databases. Based on title/abstract and full text, articles were selected using predetermined inclusion and exclusion criteria. Information on workplace-based assessment tools was extracted using data coding sheets. The methodological quality of studies was assessed using the medical education research study quality instrument (MERSQI). RESULTS: The search yielded 6,371 articles (180 were evaluated in full text). In total, 80 articles were included, identifying 67 assessment tools. Only a few studies explicitly mentioned assessment tools used as a resource for entrustment decisions. Validity evidence was frequently reported, and the MERSQI score was 10.0 on average. CONCLUSIONS: Many workplace-based assessment tools were identified that potentially support learners with feedback on their development and support supervisors with providing feedback. As expected, only few articles referred to entrustment decisions. Nevertheless, the exciting tools or the principals could be used for entrustment decisions, supervision level, or autonomy

Assessment Tools for Feedback and Entrustment Decisions in the Clinical Workplace: A Systematic Review

BACKGROUND: Entrustable Professional Activities (EPAs) combine feedback and evaluation with a permission to act under a specified level of supervision and the possibility to schedule learners for clinical service. This literature review aims to identify workplace-based assessment tools that indicate progression toward unsupervised practice, suitable for entrustment decisions and feedback to learners. METHODS: A systematic search was performed in the PubMed, Embase, ERIC, and PsycINFO databases. Based on title/abstract and full text, articles were selected using predetermined inclusion and exclusion criteria. Information on workplace-based assessment tools was extracted using data coding sheets. The methodological quality of studies was assessed using the medical education research study quality instrument (MERSQI). RESULTS: The search yielded 6,371 articles (180 were evaluated in full text). In total, 80 articles were included, identifying 67 assessment tools. Only a few studies explicitly mentioned assessment tools used as a resource for entrustment decisions. Validity evidence was frequently reported, and the MERSQI score was 10.0 on average. CONCLUSIONS: Many workplace-based assessment tools were identified that potentially support learners with feedback on their development and support supervisors with providing feedback. As expected, only few articles referred to entrustment decisions. Nevertheless, the exciting tools or the principals could be used for entrustment decisions, supervision level, or autonomy

Am I ready for it? Students’ perceptions of meaningful feedback on entrustable professional activities

Background Receiving feedback while in the clinical workplace is probably the most frequently voiced desire of students. In clinical learning environments, providing and seeking performance-relevant information is often difficult for both supervisors and students. The use of entrustable professional activities (EPAs) can help to improve stu-dent assessment within competency-based education. This study aimed to illustrate what students' perceptions are of meaningful feedback viewed as conducive in preparing for performing EPA unsupervised. Methods In a qualitative multicentre study we explored stu-dents' perceptions on meaningful feedback related to EPAs in the clinical workplace. Focus groups were conducted in three different healthcare institutes. Based on concepts from the literature, the transcripts were coded, iteratively reduced and displayed. Results Participants' preferences regarding meaningful feedback on EPAs were quite similar, irrespective of their institution or type of clerkship. Participants explicitly men-tioned that feedback on EPAs could come from a variety of sources. Feedback must come from a credible, trustworthy Electronic supplementary material The online version of this article (doi: 10.1007/s40037-017-0361-1) contains supplementary material, which is available to authorized users. supervisor who knows the student well, be delivered in a safe environment and stress both strengths and points for improvement. The feedback should be provided immedi-ately after the observed activity and include instructions for follow-up. Students would appreciate feedback that refers to their ability to act unsupervised. Conclusion There is abundant literature on how feedback should be provided, and what factors influence how feed-back is sought by students. This study showed that students who are training to perform an EPA unsupervised have clear ideas about how, when and from whom feedback should be delivered. What this paper adds To enhance the educational environment in the workplace, meaningful feedback and valid assessment of students are required. As the literature shows, it is difficult to success-fully apply workplace-based assessments in clinical prac-tice. The use of entrustable professional activities (EPAs) can help to improve student assessment within competency-based education. However, there still is little evidence about what students perceive as useful information to prepare for performing an EPA with less than full supervision. This study aimed to illustrate what students' perceptions are of meaningful feedback viewed as conducive to prepare for the performance of an EPA unsupervised Am I ready for it? Students' perceptions of meaningful feedback on entrustable professional activitie