title: Use of Milestones and Development of Entrustable Professional Activities in 2 Hematology/Oncology Training Programs.
abstract: BACKGROUND
  The Next Accreditation System (NAS) increases the focus on educational outcomes and meaningful evaluation of learners. This requires that key clinical faculty develop new assessment formats such as entrustable professional activities (EPAs).
  
  
  OBJECTIVE
  To build and develop milestone-based assessment tools supporting 5 EPAs for a hematology/oncology fellow continuity clinic, and to educate key clinical faculty regarding the Clinical Competency Committee (CCC) and the NAS.
  
  
  METHODS
  Program directors from 2 hematology/oncology fellowship programs developed 5 EPAs for continuity clinic evaluation supported by milestone-based assessment. The program directors met to create a unified CCC charter. Key clinical faculty helped to develop a milestone-based evaluation of fellow continuity clinic through creation of 5 hematology/oncology-specific EPAs. Formal entrustment regarding EPAs was deliberated by the CCC.
  
  
  RESULTS
  A total of 18 fellows were evaluated. Clinical Competency Committee deliberation at each institution took approximately 10 minutes per fellow for discussion and decision regarding entrustment for all 5 EPAs supporting continuity clinic. One-third of postgraduate year (PGY)-4s, 50% of PGY-5s, and 100% of PGY-6s were deemed competent in all 5 EPAs by the CCC.
  
  
  CONCLUSIONS
  All hematology/oncology trainees in San Antonio were evaluated using milestone-based assessment for continuity clinic, and entrustment decisions regarding 5 EPAs were made by the CCC. This project may provide other programs with a sound basis for adoption and further development of the next generation of evaluation tools at their institutions. Entrustable professional activities that are rotation specific should be used as a starting point for linking to the competencies, subcompetencies, and the reporting milestones.
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Shumway
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Dacus
authors.forename: Kate I
authors.initials: KI
authors.lastname: Lathrop
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Hernandez
authors.forename: Maria
authors.initials: M
authors.lastname: Miller
authors.forename: Anand B
authors.initials: AB
authors.lastname: Karnad
mesh_terms: D000068:Accreditation / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods*; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D006405:Hematology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008495:Medical Oncology / Q000193:education*; D016730:Program Development; D015397:Program Evaluation; D013781:Texas; D014481:United States