Entrustable Professional Activities (EPAs) for Newly Graduated Nurses: A Preliminary Study in Thailand

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Pitsini Mongkhonsiri
Jureerat Kitsomporn
Streerut Thadakant
Sulee Tongvichean
Soiy Anusornteerakul
Wacharee Amornrojanavaravutti
Kittiporn Nawsuwan
Penpak Luk-in
Krongkaew Rastsadondee
Ampicha Nawai
Nualyai Pitsachart
Chonnipha Jaidee

Abstract

The purpose of this study was to establish a list of nursing psychomotor skills identified to be Entrustable Professional Activities (EPAs) for newly graduated nurses. Twelve nursing instructors from 8 nursing schools discussed and established 147 nursing activities taught in the nursing and midwifery curriculum in Thailand. The list of these activities was constructed to be a questionaire and approved by three experts. Each activity was classified into 5 levels of performance. Experts’ opinions were collected by the two-round Delphi technique from 240 registered nurses recruited by purposive sampling. The participants had been working in the nursing profession for 10-46 years in mixing fields of nursing education and services both in public and private institutes comprised of 119 nursing instructors from 8 nursing institutes and 121 registered nurses from various levels of service sectors. Data was analysed by frequency, percentage, mean and median. Results showed classification of the 147 nursing activities into 4 levels of EPAs which were 41 (27.89 %), 83 (56.46 %), 22 (14.97 %) and 1 (0.68 %) for EPA level’s 5, 4, 3, and 2, respectively. No activity determined to be EPA level 1. There was a total of 124 EPAs (84.35 %) classified to be EPAs level 4 and 5, which experts expected newly graduated nurses to perform entrustedly with distanced supervision or without supervision. The remaining 23 activities (15.65 %) were allowed for new nurses to perform but with close supervision. However, there were only 12 activities of EPAs considered to be level 5 that obtained over 80 % frequencies of the experts’ opinions. This research was the first study to identify EPAs for nurses newly graduated from the nursing and midwifery curriculum in Thailand. The result is useful for nursing pedagogy development, especially for concrete assessments.

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How to Cite
1.
Mongkhonsiri P, Kitsomporn J, Thadakant S, Tongvichean S, Anusornteerakul S, Amornrojanavaravutti W, Nawsuwan K, Luk-in P, Rastsadondee K, Nawai A, Pitsachart N, Jaidee C. Entrustable Professional Activities (EPAs) for Newly Graduated Nurses: A Preliminary Study in Thailand. NJPH (วารสาร พ.ส.) [Internet]. 2021 Apr. 25 [cited 2022 Sep. 28];31(1):161-76. Available from: https://he02.tci-thaijo.org/index.php/tnaph/article/view/250662
Section
บทความวิจัย

References

1. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet 2010; 376(9756):1923-1958. doi:10.1016/S0140-6736(10)61854-5.

2. Mulder H, Ten Cate O, Daalder R, Berkvens J. Building a competency- based workplace curriculum around entrustable professional activities: the case of physician assistant training. Medical Teacher 2010;32(10): e453-e459. doi: 10.3109/0142159X.2010.513719.

3. Shaughnessy AF, Jennifer Sparks J, Cohen-Osher M, Goodell KH, Sawin GL, Gravel Jr J. Entrustable professional activities in family medicine. Journal of Graduate Medical Education 2013;March:112-118.

4. Ten Cate O. Entrustable of professional activities and competency-based training. Medical Education 2005;39(12):1176-7.

5. Ten Cate O, Sheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Academic Medicine 2007;82(6):542-7.

6. Wisman-Zwarter N, van der Schaaf M, Ten Cate O, Jonker G, van Klei WA, Hoff RG. Transforming the learning outcomes of anaesthesiology training into entrustable professional activities: a delphi study. European Journal of Anaesthesiology 2016;33:559–67.

7. Kwan J, Crampton R, Mogensen LL, Weaver R, Cees PM, van der Vleuten CPM, et al. Bridging the gap: a five stage approach for developing specialty-specific entrustable professional activities. Medical Education 2016;16:117.doi:10.1186/s12909-016-0637-x.

8. Fessler HE, Addrizzo-Harris D, Beck JM, Buckley JD, Pastores SM, Piquette CA, et al. Entrustable professional activities and curricular milestones for fellowship training in pulmonary and critical care medicine: Report of a multisociety working group. Chest 2014;146(3):813–34.

9. Rose S, Fix OK, Shah BJ, Jones TN, Szyjkowski RD. Entrustable professional activities for gastroenterology fellowship training. Gastroenterology 2014;147(1):233–42.

10. Bhuyan N, Miser WF, Dickson GM, Jarvis JW, Maxwell L, Mazzone M, et al. From family medicine milestones to entrustable professional activities (EPAs). Annals of Family Medicine 2014;12:380–1.

11. Hauer KE, Soni K, Cornett P, Kohlwes J, Hollander H, Ranji SR, et al. Developing entrustable professional activities as the basis for assessment of competence in an internal medicine residency: a feasibility study. Journal of General Internal Medicine 2013;28(8):1110–4. doi:10.1007/s11606-013-2372-x.

12. Ten Cate O. Entrustment as assessment: recognizing the ability, the right, and the duty to act. Journal of Graduate Medical Education [Internet] 2016 [cited 2020 June 13] Available from:https://doi.org/10.4300/JGME-D-16-00097.1

13. Surjadi M, Stringari-Murray S, Saxe JAM. Entrustable professional activities in nurse practitioner education. The Journal for Nurse Practitioners [Internet] 2019 [cited 2020 June 13] Available from:https://doi.org/10.1016/j.nurpra.2018.12.030

14. Sue HK, Elda GR, Jean AP. Making a case for entrustable professional activities for nurse practitioners in emergency care. Advanced Emergency Nursing Journal 2017;39(2):77–80.doi:10.1097/TME.0000000000000146.

15. Wagner LM, Dolansky MA, Englander R. Entrustable professional activities for quality and patient safety. Nursing Outlook [Internet] 2018 [cited 2020 June 3];66(3) Available from: https://doi.org/10.1016/j.outlook.2017.11.001

16. Whyte IVJ, Hauber R, Ward P. The effect of a structured internship on the clinical performance of novice nurses? Journal of Nursing Education and Practice 2014;4(11):7481.

17. Wannakrairoj P, Rujkornkan D, Buranatriwate S, Wisaijorn T, Preyanont L. Commentary for developing health professional education: specific issues for teaching and learning reform. The National Health Professional Education Foundation 2017. The Graphico System Company, Nonthaburi. (in Thai)

18. Thailand Nursing and Midwifery Council. Announcement of Thailand Nursing and Midwifery Council: competency of professional nurse. [Internet]. 2009[cited 2018 Dec 2]. Available from: http://110.164.68.234/
nurse_/files/ethics04.pdf (in Thai)

19. Preawnim A. A survvey study of desired characteristics evaluation of graduated nures in the academic 2016 according to perception of stakeholder users, Faculty of Nursing, Bnagkokthonburi University, Bangkok.; 1992 (in Thai)

20. Raetong P, Harnirattisai T. Role change experience: from nursing students to registered nurses. The Journal of Nursing Council 2012;27(2),51-62. (in Thai)

21. Tamarpirat N, Oumtanee A. Being a newly graduated nurse working under supervision of a mentor. Journal of The Royal Thai Army Nurses 2017;18(supplement issue: April),32-40. (in Thai)

22. Lowden K, Hall S, Elliot D, Lewin J. Employers’ perceptions of employability skills of new graduates. London, UK: Project Report. Edge Foundation; 2011.

23. Aylward M, Nixon J, Gladding S. An entrustable professional activity (EPA) for handoffs as a model for EPA assessment development. Academic Medicine [Internet]. 2014 [cited 2019 August 22]. Available from: https://europepmc.org/article/med/24892402

24. Ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der Schaaf M. Curriculum development for the workplace using entrustable professional activities (EPAs):AMEE Guide No. 99, Medical Teacher 2015;37(11):983-1002.

25. Lau ST, Ang E, Samarasekera DD, Shorey S. Development of undergraduate nursing entrustable professional activities to enhance clinical care and practice. Nurse Education Today [Internet]. 2020 [cited 2020 May 5] Available from: https://doi.org/10.1016/j.nedt.2020.104347