Development and Use of Observable Practice Activities in Graduate Medical Education: A 10-Year Experience: Invited...

Since the introduction of educational milestones by the Accreditation Council for Graduate Medical Education, residency programs have sought to identify the optimal approach to assess progression through these milestones. Entrustable Professional Activities and Observable Practice Activities are tools that can be customized for each medical specialty and utilized to assess a learner's advancement. An effective process for creating and implementing specialty-specific Entrustable Professional Activities and their corresponding Observable Practice Activities into the residency curriculum remains unclear.

The aim of this report is to present a 10-yr experience in developing and using Observable Practice Activities to assess residents' performance and competence in physical medicine and rehabilitation.

A physical medicine and rehabilitation residency program developed 63 Observable Practice Activities in 2014 and subsequently incorporated them into their curriculum in 2015. These have been in active use since then. Assessment of the tool's effectiveness and ease of use were evaluated and monitored through annual surveys of residents and faculty. Generalizability was assessed by another physical medicine and rehabilitation residency program. Finally, the value of the process was evaluated when shared with the Physical Medicine and Rehabilitation Residency and Fellowship Directors Council, a multispecialty competency based medical education round table, and in a competency based medical education workshop of the American Board of Physical Medicine and Rehabilitation.

At the time of this report, 100% of residents, 65 total, have utilized the tool. The Observable Practice Activities covered the core physical medicine and rehabilitation conditions, allowed residents real time monitoring of their progression through each domain, and were felt to be a valuable tool by faculty, residents, and education leaders.

Observable Practice Activities can be crafted and effectively incorporated into a physical medicine and rehabilitation residency curriculum to assess resident progression through the Accreditation Council for Graduate Medical Education milestones.