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A Modified Delphi Consensus Approach to Define Entrustable Professional Activities for Neurocritical Care Advanced

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Summary
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Consensus-based entrustable professional activities (EPAs) were developed for neurocritical care (NCC) advanced practice providers (APPs). These EPAs met quality standards and are considered important across various practice settings, aiding in curriculum development.

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Area of Science:

  • Neurocritical Care
  • Medical Education
  • Advanced Practice Providers

Background:

  • Neurocritical care (NCC) requires specialized skills for advanced practice providers (APPs).
  • Standardized assessment tools are needed to ensure competency of NCC APPs.
  • Entrustable Professional Activities (EPAs) offer a framework for competency-based assessment.

Purpose of the Study:

  • To define consensus EPAs for NCC APPs.
  • To establish validity evidence for these EPAs.
  • To evaluate factors influencing supervisor entrustment expectations for NCC APPs.

Main Methods:

  • A modified Delphi consensus process involving NCC APPs and physicians.
  • Utilized the EQual rubric to assess EPA quality and structure.
  • Assessed generalizability by clinicians outside academic medical centers via electronic surveys.

Main Results:

  • Developed six core EPAs for NCC APPs covering medical knowledge, procedures, and communication.
  • All core EPAs met predefined quality and structure standards.
  • Most clinicians rated the core EPAs as very important or mandatory, irrespective of practice setting.

Conclusions:

  • Expert consensus successfully created high-quality EPAs for NCC APPs.
  • These EPAs are relevant across diverse practice settings.
  • The developed EPAs can guide curriculum design and assessment for NCC APPs and inform similar efforts in other critical care subspecialties.