Implementing Cbme Assessments as Potential Professional Identity Enhancement Tools: Exploring the Feasibility of Entrustable Professional Activities/Milestones Assessment and Its Impact on Emergency Physicians’ Professional Identities

Background Exposure and immersion in the medical environment through practice, entrustment with clinical tasks, receiving feedback from mentors, and interacting with colleagues form an integral part of the work place socialization and professional development of trainees. To ensure the professional development of trainees, clinical educators have to consider different factors when making decisions about the clinical tasks to assign to their trainees and the level supervision required for each task. Results from trainees’ assessments have been used as one of the significant contributors to the entrustment decision making process. Assessment of various Enstrustable Professional Activities (EPAs) and milestones has emerged as potential tools for clinical educators to rely on when making entrustment decisions. However, there is limited literature on the feasibility, of EPAs/milestones assessment, the significance of the contribution made by EPAs/milestones assessment results in the entrustment decisions making process and the impact of entrustment feedback on the Emergency Medicine residents’ (EMRs) professional identities. Objectives This is a nation-wide project focusing on Emergency Physicians (EPs) and EMRs in Taiwan. The first objective is to examine the feasibility of assessment tools that are currently used to assess EMRs in Taiwan and examine EPs’ and EMRs’ attitudes towards these tools. We will also examine EPs’ and EMRs’ conceptualization of entrustment and their pre-conceived attitudes towards EPAs/milestones assessment. Concurrently, we will identify factors that influence entrustment decisions, reliability of those decisions and explore different opinions of EPs and EMRs on the degree of significance of each factor to the final entrustment decision and to the perceived reliability of entrustment feedback. Furthermore, we will explore how transparency in the path to entrustment influences the development of evaluative judgment of EPs and EMRs. By examining the stakeholder’s attitudes, feasibility and fidelity of EPAs/milestones assessments, we will also explore the perceived impact and contribution of EPAs/milestones assessments on EPs’ and EMRs’ development of evaluative judgement. Consequently, using a longitudinal approach, we will explore the association between EPAs/milestones assessment and professional identities overtime. Methods We will use semi-structured interviews to identify EPs’ and EMRs’ perceived impact of current assessment methods and attitudes towards current assessment methods. The interviews will also examine the pre-implementation attitudes towards EPAs/ milestones assessments. We will gain insight on the factors that influence the level of supervision, entrustment and perceived reliability of entrustment decision. By ranking the factors according to their priorities, we will be able to determine each factors’ contribution to the entrustment decision making process and to the reliability of entrustment decisions. We will also gather different opinions on how transparency in the entrustment decision process impacts EPs’ evaluative judgment and EMRs’ self-evaluative judgment of clinical competency. Quantitative analysis will be conducted to explore the associations between longitudinal data from EMRs’ EPAs/milestones assessment scores, and emergency medicine professional identity scale (EMPIS). Once the implementation of EPAs/ milestones assessments is well under way, we will examine EPs’ and EMRs’ perceived impact and overall experience of the use of EPAs/milestones as assessment tools using semi-structured interviews.

Project ID:PF10901-1129
External Project ID:MOST108-2511-H182-007-MY2