Appraisal of the entrustable professional activities (EPAs) patient care provider domain by North Dakota pharmacists
Background: Entrustable Professional Activities (EPAs) are the latest addition to a list of professional competencies that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy.
Objective: The study’s objective is to assess the use of Core EPAs in the patient care domain (by practice setting, position, and preceptor status) in contemporary pharmacy practice.
Methods: This survey assessed the EPA activities of pharmacists practicing in North Dakota. The pharmacists were asked “how many times in the past 30 days have you delivered the following services in your practice setting?” Response options were: 0, 1, 2, 3, 4, and 5 or more times.
Results: Of 990 potential respondents, 457 pharmacists (46.1%) returned a survey, and 107 (10.8%) answered every survey item in the patient care domain. Respondents reported that the highest rated activity items “Collect information to identify a patient's medication-related problems and health-related needs,” and “Analyze information to determine the effects of medication therapy, identify medication-related problems, and prioritize health-related needs” were performed an average of 3.9 times per week (SD=1.8), and 3.8 times per week (SD=2.0), respectively. Both of these items, were reported for 70% of the respondents at 5 or more times per week. For these items, the highest reported practice setting was ‘other’ practice settings (e.g., long-term care, community health centers) followed by chains, hospitals, and independent pharmacies. By position, clinical pharmacists and preceptors reported the highest activity levels for most EPAs and supportive example tasks.
Conclusions: This study provides empirical evidence suggesting (but not proving) that EPAs have potential as a means to assess outcomes in pharmacy education and practice. Our study sets the stage for future work that further refines and assesses core EPA activities and supportive example tasks to measure the impact of how this process relates to outcomes of care.
ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med. 2007;82(6):542-547. https://doi.org/10.1097/ACM.0b013e31805559c7
ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39(12):1176-1177. https://doi.org/10.1111/j.1365-2929.2005.02341.x
Hauer KE, Kohlwes J, Cornett P. Identifying entrustable professional activities in internal medicine training. J Grad Med Educ. 2013;5(1):54-59. https://doi.org/10.4300/JGME-D-12-00060.1
Pittenger AL, Chapman SA, Frail CK, Moon JY, Undeberg MR, and Orzoff JH. Entrustable professional activities for pharmacy practice. Am J Pharm Educ. 2016;80(4):57. https://doi.org/10.5688/ajpe80457
Haines ST, Pittenger A, Plaza C. Describing entrustable professional activities is merely the first step. Am J Pharm Educ. 2017;81(1):18. https://doi.org/10.5688/ajpe81118
Association of American Medical Colleges. The core entrustable professional activities for entering residency. https://www.aamc.org/initiatives/coreepas/ (accessed Nov 20, 2018).
Shaughnessy AF, Sparks J, Cohen-Osher M, Goodell KH, Sawin GL, Gravel J Jr. Entrustable professional activities in family medicine. J Grad Med Educ. 2013;5(1):112-118. https://doi.org/10.4300/JGME-D-12-00034.1
The American Board of Pediatrics. Entrustable professional activities. https://www.abp.org/entrustable-professional-activities-epas (accessed Nov 20, 2018).
Jarrett JB, Berenbrok LA, Goliak KL, Meyer SM, Shaughnessy AF. Entrustable professional activities as a novel framework for pharmacy education. Am J Pharm Educ. 2018;82(5):6256. https://doi.org/10.5688/ajpe6256
Pittenger AL, Copeland DA, Lacroix, MM, Masuda QN, Mbi P, Medina MS, Miller SM, Stolte SK, Plaza CM. Report of the 2016-17 academic affairs standing committee: EPAs implementation roadmap. Am J Pharm Educ. 2017;81(5):S4. https://doi.org/10.5688/ajpe815S4
Haines ST, Gleason BL, Kantorovich A, McCollum M, Pittenger AL, Plaza CM, Stolte SK, Trujillo JM. Report of the 2015-2016 Academic Affairs Standing Committee. Am J Pharm Educ. 2016;80(9):S20. https://doi.org/10.5688/ajpe809S20
Haines ST, Pittenger AL, Stolte DK, Plaza CM, Gleason BL, Kantorovich A, McCollum M, Trujillo JM, Copeland DA, Lacroix MM, Masuda QN, Mbi P, Medina MS, Miller SM. Core entrustable professional activities for new pharmacy graduates. Am J Pharm Educ. 2017;81(1):S2. https://doi.org/10.5688/ajpe811S2
Scott DM, Naughton C, Petry N, Friesner D. Assessment of Practice Management Entrustable Professional Activities (EPAs) by Pharmacists in North Dakota. Am J Pharm Educ [ahead of print]. https://doi.org/10.5688/ajpe7486
Scott DM. Assessment of pharmacists’ perception of patient care competence and need for training in rural and urban areas in North Dakota. J Rural Health. 2010;26(1):90-96. https://doi.org/10.1111/j.1748-0361.2009.00270.x
Draugalis J, Coons S, Plaza C. Best practices for survey research reports: A synopsis for athors and reviewers. Am J Pharm Educ. 2008;72(1):11. https://doi.org/10.5688/aj720111
Scott D, Strand M, Undem T, Anderson G, Clarens A, Liu X. Assessment of pharmacists' delivery of public health services in rural and urban areas in Iowa and North Dakota. Pharm Pract (Granada). 2016;14(4):836. https://doi.org/10.18549/PharmPract.2016.04.836
Dillman D, Smyth J, Christian L. Internet, Mail, and Mixed Mode Surveys: The Tailored Design Method. 3rd edition. Hoboken, NJ: John Wiley and Sons; 2009.
Nulty D. Adequacy of response rates to online and paper surveys: What can be done? Assess Eval High Educ 2008;33(3):301-314. https://doi.org/10.1080/02602930701293231
Slack MK, Baidoo B. Chapter 10: Bivariate analysis and comparing groups. In: Principles of research design and drug literature evaluation. Aparasu R, Bentley J, eds. Burlington, MA: Jones and Bartlett; 2015.