Changing Medical Education When Change Is Hard: Implementing an Interdepartmental Entrustable Professional Activity

Area of Science:

• Medical Education
• Healthcare Management
• Competency-Based Assessment

Background:

• Entrustable Professional Activities (EPAs) are pivotal in graduate medical education (GME) for competency-based assessment.
• Implementing new systems like EPAs often encounters resistance to change.
• The "Switch" model offers a framework for managing organizational change.

Purpose of the Study:

• To describe the change management principles applied during the institution of an EPA.
• To evaluate the effectiveness of the "Switch" model in facilitating EPA implementation.

Main Methods:

• The "Switch" model was employed to implement a trauma resuscitation EPA.
• A comparative analysis of EPA evaluations was conducted between the Departments of Emergency Medicine (EM) and Surgery.
• A survey assessed EM faculty perceptions of key implementation principles.

Main Results:

• 78% of EM faculty identified "Switch" principles as crucial for successful EPA implementation.
• The EM department significantly outperformed the Surgery department in EPA evaluations.
• Limitations in the Surgery department's approach could have been mitigated by "Switch" principles.

Conclusions:

• Change management principles provide a robust framework for successful EPA implementation in GME.
• "Switch" model principles are instrumental in overcoming resistance and ensuring effective adoption of EPAs.