Related Experiment Video
Updated: Mar 22, 2026
Development of a Virtual Reality Assessment of Everyday Living Skills
Published on: April 23, 2014
Patients, Nurses, and Physicians Working Together to Develop a Discharge Entrustable Professional Activity Assessment
Lauren B Meade1, Kathleen Heist Suddarth, Ronald R Jones
1L.B. Meade is Macy Faculty Scholar, Baystate Medical Center, Springfield, and associate professor of medicine, Tufts University School of Medicine, Boston, Massachusetts.K.H. Suddarth is associate program director for internal medicine and assistant professor of medicine, University of Colorado Denver School of Medicine, Denver, Colorado.R.R. Jones is associate program director in internal medicine, Summa Health Systems, Akron, and associate professor of medicine, Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio.A.K. Zaas is program director for internal medicine and associate professor, Duke University School of Medicine, Durham, North Carolina.T. Albanese is formerly manager of medical education, Summa Health System, Akron, Ohio.K. Yamazaki is outcome assessment research associate, Accreditation Council for Graduate Medical Education, Chicago, Illinois.C.W. O'Malley is program director in internal medicine and assistant professor of medicine, University of Arizona College of Medicine, Phoenix, Arizona.
Problem:
The Accreditation Council for Graduate Medical Education milestones were written by physicians and thus may not reflect all the behaviors necessary for physicians to optimize their performance as a key member of an interprofessional team.
Approach:
From April to May 2013, the authors, Educational Research Outcomes Collaborative leaders, assembled interprofessional team discussion groups, including patients or family members, nurses, physician trainees, physician educators, and other staff (optional), at 11 internal medicine (IM) programs. Led by the site's principal investigator, the groups generated a list of physician behaviors related to the entrustable professional activity (EPA) of a safe and effective discharge of a patient from the hospital, and prioritized those behaviors.
Outcomes:
A total of 182 behaviors were listed, with lists consisting of between 10 and 29 behaviors. Overall, the site principal investigators described all participants as emerging from the activity with a new understanding of the complexity of training physicians for the discharge EPA. The authors batched behaviors into six components of a safe and effective discharge: medication reconciliation, discharge summary, patient/caregiver communication, team communication, active collaboration, and anticipation of posthospital needs. Specific, high-priority behavior examples for each component were identified, and an assessment tool for direct observation was developed for the discharge EPA.
Next Steps:
The authors are currently evaluating trainee and educator perceptions of the assessment tool after implementation in 15 IM programs. Additional next steps include developing tools for other EPAs, as well as a broader evaluation of patient outcomes in the era of milestone-based assessment.
Related Concept Videos
01:31Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:17Flow Sheet
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
01:24Nursing Process for Patient and Caregiver Teaching I: Assessment and Diagnosis
It is critical to determine the patient's learning needs during the assessment. Determination of learning needs compounds data...
01:21Methods of Documentation III: PIE
01:03Data Validation
Nursing assessment guides are generally based on holistic models rather than medical...