Challenge
Residency is a step in time of helping residents grow in all aspects of being competent and effective physicians. To aid in this process, governing bodies have developed systems of assessment for core abilities in the general area of being a physician as well as in the specialties physicians desire to practice. Feedback from attending physicians and the ability to see their learning trajectory is it is essential to their development. We need to create a system where; 1. Residents receive immediate feedback in the workplace via a convenient endpoint that endures the environment they are in, 2. Residents and Faculty can view past assessments for feedback and learning, and 3. See and compare Resident progress over time ( quantitative and qualitative ) in order to make good competency decisions.
Solution
Create a system in the mobile app that brings in Entrustable Professional Activities (EPAs) assessments so they can capture feedback in real-time or request it by quickly pulling out their mobile phone. Allow the user to easily select the EPA related to the medical event that just occurred and the assessor who was with them. The first step in this system is the management and delivery of EPAs for the program.
Administrators for the programs have control of which EPAs are delivered to the residents and faculty for assessment. The software gathers the EPAs from the specialty’s published site. Those EPAs are displayed with a toggle to turn them on and off. Once on, those EPAs are available for assessment.
Administrators View
For the Resident experience, the solution needs to accomplish the following: the ability to create/initiate an EPA assessment, and show an overview of the EPAs associated with their program (which typically range from 10 to 20 of them depending on their program’s set up), how many of each have been completed, details of those completed so they can assimilate the feedback, and be aware of EPAs that they have not been assessed on so if one were to occur during their shift they could make that request.
Resident workflow
For the Faculty who will be doing the assessments, it will be the first entry point for the use of the mobile app and the beginning of the experience tailored to the journey of faculty of a residency program. Starting simple with the focus on requested assessments. Faculty will be delivered a task list of requests and the ability to view those they have completed. Next, the option to initiate an assessment in the same way the resident would with the difference being selecting a resident and not an assessor.
Faculty workflow
Assessment View
The administration needs to be able to track the residents’ progress in their programs. A reporting tool was developed to aid in this process with the ability to export for sharing. It gives them a comprehensible view of all of their residents’ assessments.
Reporting View
Insights
This system, Direct Observations, created a foundation for residency programs to move into as they journey into Entrustable Professional Activities for specialties that are standardizing assessments to better facilitate the education and growth of residents. Feedback is essential in the growth of any person, the improved process for a resident is not only beneficial for them but also to all of us as they dedicated their lives to help.
