Multi-stakeholder Validation of Entrustable Professional Activities in Family Medicine
Bibliographic record
Abstract
Abstract Background:The development of Entrustable Professional Activities (EPAs) has generally focused on expert panel approaches, which are often limited to physician stakeholders. Optimally, a much wider group of stakeholders should be consulted and include all people gaining value from trainees’ patient care performance. The present study explored the perceptions of a variety of stakeholder groups regarding the relevance and comprehensiveness of EPAs developed for a Canadian Family Medicine Residency program.Methods: Through the use of an online survey consisting of dichotomous and open-ended questions, this study explored and compared the perceptions of a variety of stakeholder groups (policy makers, health administrators, health professionals, teachers, and public) regarding the relevance and comprehensiveness of 25 EPAs articulated by a family medicine residency program.Results:Agreement on appropriateness of the 25 articulated EPAs ranged from 90% to 100%, displaying a high level of alignment between stakeholders. Stakeholders identify two gap areas within the EPA framework: 1) provision of surgical assistance and 2) addictions care.Conventional content analysis identified three key themes that cut across multiple areas of the survey: 1) Interprofessional collaboration (IPC), 2) Inclusivity, and 3) Scope of EPAs. Comparative analysis consisted of exploring agreements, gaps, and other differences of perspectives between stakeholder groups. Although many of the stakeholder groups made comments regarding IPC and Inclusivity, the patient group in particular was more likely to raise these themes. Comments from patient groups were also overall more general, identifying overarching trends rather than specific pinpoint issues. Physicians, other health professionals, and resident groups, (Ie. health professional groups) on the other hand tended to answer with much more specificity, identifying issues relating to scope of EPAs.Conclusions: The present study demonstrates that a multi-stakeholder approach can feasibly be used to validate an EPA framework. In addition to confirming that a previously articulated set of EPAs largely reflected the range of activities expected of family physicians serving a population, it identified a number of potential areas of improvement in the framework.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.133 | 0.145 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.010 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".