Document Type : Original Article
Authors
1 Department for Educational Development and Pathology and Laboratory Medicine, The Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan
2 Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan
Abstract
Introduction: The concept of Entrustable Professional Activities (EPAs) is central to competency-based medical education, which enables the assessment and guidance of learners in clinical settings. While EPAs have been widely adopted in various medical specialties, their application in hematopathology training remains underexplored. This study aimed to develop and validate
a set of Entrustable Professional Activities (EPAs) tailored for hematology training in pathology residency programs.
Methods: This cross-sectional Delphi study was conducted in 2023 at Aga Khan University Hospital, Pakistan, to seek consensus for EPAs. Sixteen essential EPAs for hematology postgraduate education were identified through literature review and faculty expertise, aligning with core ACGME competencies. Teaching/learning and assessment strategies were detailed for each EPA. The modified Delphi method, involving two iterative rounds, was employed to achieve expert consensus. The panel comprised 22 experts, 16 of whom participated from various institutions.
Results: In the first Delphi round, 14 out of 16 EPAs reached the desired consensus of more than 80%, along with certain teaching/assessment strategies. The second round aimed to finalize
consensus on the remaining items. Two EPAs related to Platelet Function Disorders and Von Willebrand Disease failed to reach the predefined consensus criteria. Lectures as a teaching strategy and certain assessment strategies also lacked consensus. The study concluded with the acceptance and finalization of 14 EPAs and their associated teaching and assessment strategies.
Conclusions: The study identified essential EPAs, competencies, and effective teaching and assessment strategies. This collaborative effort advances hematology medical education and guides curriculum development, preparing competent hematologists for the unique context of the Pakistani and related healthcare systems.
Highlights
Keywords
- McCloskey CB, Domen RE, Conran RM, Hoffman RD, Post MD, Brissette MD, et al. Entrustable professional activities for pathology: recommendations from the College of American Pathologists Graduate Medical Education Committee. Acad Pathol. 2017;4:2374289517714283.
- Tu CY, Huang KM, Cheng CH, Lin WJ, Liu CH, Yang CW. Development, implementation, and evaluation of entrustable professional activities (EPAs) for medical radiation technologists in Taiwan: a nationwide experience. BMC Med Educ. 2024;24(1):95.
- Ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der Schaaf M. Curriculum development for the workplace using entrustable professional activities (EPAs): AMEE guide no. 99. Med Teach. 2015;37(11):983-1002.
- Peters H, Holzhausen Y, Boscardin C, Ten Cate O, Chen HC. Twelve tips for the implementation of EPAs for assessment and entrustment decisions. Med Teach. 2017;39(8):802-7.
- Shorey S, Lau TC, Lau ST, Ang E. Entrustable professional activities in health care education: a scoping review. Med Educ. 2019;53(8):766-77.
- Alharbi LA, Cheikh M, Alotaibi ME, Alkhotani AA, Alim HM, Almalki F, et al. Developing and Validating Entrustable Professional Activities (EPAs) for Rheumatology Fellowship Training Programs in Saudi Arabia: A Delphi Study. Advances in Medical Education and Practice. 2024;15:845-56.
- White K, Qualtieri J, Courville EL, Beck RC, Alobeid B, Czuchlewski DR, et al. Entrustable professional activities in hematopathology pathology fellowship training: consensus design and proposal. Acad Pathol. 2021;8:2374289521990823.
- Ahmed A, Aman A, Khan S, Khan MF, Ullah H, Ahmed SSh, et al. Improving Postgraduate Anaesthesiology Training in a Low-Middle Income Country by Embracing the New Trends in Medical Education. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP. 2023;33(7):815-9.
- Shaikh AJ, Ikram B. Enhancing Postgraduate Medical Education: Upscaling and Recognition of Pakistan’s Training. Journal of the College of Physicians and Surgeons Pakistan. 2024;34(7):860-1.
- Vaqar M, Tariq M, Khan MR, Khan S, Riaz Q, Mahmood S, et al. A Journey of Innovation: 40 years of Pioneering Medical Education at the the Aga Khan University Medical College in Karachi, Pakistan. Postgrad Med J. 2024;100(1183):350-7.
- Edgar L, McLean S, Hogan SO, Hamstra S, Holmboe ES. The milestones guidebook. USA: Accreditation Council for Graduate Medical Education; 2020. pp. 6-19.
- Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401-9.
- Jünger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med. 2017;31(8):684-706.
- Bryant BH, Anderson SR, Brissette M, Childs JM, Gratzinger D, Johnson K, et al. National pilot of entrustable professional activities in pathology residency training. Academic Pathology.2024;11(2):100110.
- Sibtain A, Asad KFM, Hafsa M, Habib KA, Imran S, Farooq Gh, et al. From Practice to Proficiency: Evaluation of a Novel Workplace-Based Assessment (WBA) in a Postgraduate Chemical Pathology Residency Program in Pakistan. EJIFCC. 2024;35(2):111-9.
- Cotta CV, Ondrejka SL, Nakashima MO, Theil KS. Pathology Residents as Testing Personnel in the Hematology Laboratory: Developing Entrustable Professional Activities. Arch Pathol Lab Med. 2022;146(7):894-902.
- Ju JY, Wehrli G. The effect of entrustable professional activities on pathology resident confidence in blood banking/transfusion medicine. Transfusion. 2020;60(5):912-7.
- Ahmed M, Baloch A. Political Economy of Balochistan, Pakistan: A Critical Review. Eur Sci J. 2015;11(14):1-20.
- Naz A, Jamal MY, Amanat S, Din ujjan I, Najmuddin A, Patel H, et al. Autosomal recessive inherited bleeding disorders in Pakistan: a cross-sectional study from selected regions. Orphanet J Rare Dis. 2017;12:1-7.
- Hussain S, Baloch S, Parvin A, Najmuddin A, Musheer F, Junaid M, et al. Inherited Bleeding Disorders—Experience of a Not-for-Profit Organization in Pakistan. Clin Appl Thromb Hemost. 2018;24(8):1241-8.
- Bligh DA. What’s the Use of Lectures? Middlesex: Penguin Education; 1971.
- El-Haddad C, Damodaran A, McNeil HP, Hu W. The ABCs of entrustable professional activities: an overview of 'entrustable professional activities' in medical education. Intern Med J. 2016;46(9):1006-10.
)