Poster2 - 01: EPA INTEGRATION INTO THE SURGICAL CLERKSHIP
Shannon W Longshore, MD1, Megan Sippey, MD2, Carl Haisch, MD1, Jan Wong, MD1; 1East Carolina University, Brody SOM, 2Vidant Medical Center
Introduction: The third year Surgery Clerkship curriculum was revised to include the performance of a Root Cause Analysis (RCA) to address Entrustable Professional Activities (EPAs) 7 (Form clinical questions and retrieve evidence to advance patient care) and 13 (Identify system failures and contribute to a culture of safety and improvement). We sought to evaluate the effectiveness of this curricular change on EPA 7 and 13 functions.
Methods: Students and faculty mentors were invited to complete an anonymous online Likert survey to evaluate the effectiveness of this assignment. Questions were categorized into 3 domains: 1) acquiring and applying information, 2) communicating with the health care team, and 3) systems and vulnerabilities.
Results: The response rate was 52.4% (43/82) of students and 47.3% (9/19) of faculty. Prior to the assignment 16.6% (n=8) of students and 78% (n=7) of faculty had a strong understanding of the performance of an RCA. The assignment was believed to valuable for the students by 66.7% (6/9) of faculty and 77.7% (7/9) agreed that the assignment was worth continuing. The assignment was rated highly by 63.8% (range 48.8%-76.7%, SD=11.6%) of students and 63.9% (range 48.8%-76.7%, SD=11.7%) of faculty in the domain of competency in “acquiring and applying information”. Approximately 70% of students agreed with the statement that the assignment “has improved my ability to recognize the importance of “speaking up” in the face of real or potential errors”, yet only 51% of students agreed with the statement that the assignment “made me more comfortable in making suggestions regarding medical error(s) to attending or resident physicians”. In contrast, almost half of the faculty were neutral on whether the RCA assignment improved the student’s ability to communicate with the health care team on issues of safety. On average, 72.1% (range 58.1-81.4%, SD=9.4%) of students and 89% of faculty agreed or strongly agreed that the RCA assignment improved their ability to identify system failures and vulnerabilities.
Conclusion: The performance of an RCA during the 3rd year surgical clerkship rotation was viewed favorably by both students and surgery faculty mentors in beginning the process toward achieving competency in EPA 7 and 13.