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epa meaning medical education

The student frequently enters orders or prescriptions for the incorrect patient. after a conversation about the patient that occurs between an assessor and student after new data is collected and leads to the need to revise a differential diagnosis. Demonstrate initiative and responsibility in daily professional tasks including participation in learning activities, class presentations and patient care. The student considers the value of orders and prescriptions when recommending their use, using evidence-based principles to justify use. Medical learners must be appropriately supervised at all times to ensure patient and student safety. The presentation is poorly organized, making it difficult for the listener to follow the information. The presentation is not be appropriate for the clinical setting (i.e. arterial line placement, NG tube placement, CPR, dressing changes, venipuncture, urinary catheter placement, skin laceration repair, pap smear etc) or procedures in the OR (i.e. Does not utilize structured approaches to patient handoffs. Adapts to learners' needs on the fly. The student correctly interprets the urgency of the patient’s condition, escalates care and initiates next steps. The student may have lapses in respect toward the patient during or after the interview and examination such as failing to acknowledge the patient beyond the chief concern or dismissing the patient’s concerns. Northwestern University Feinberg School of Medicine, Tips on Maintaining a Healthy Learning Environment, Needlestick Policy & Protocol for Body Fluid Exposures Involving Visiting Students. Transition handoff is disorganized and confusing. EPA 7: Provide and receive the handover in transitions of care. Does not understand the roles and value of inter-professional team members. Consistently uses universal precautions and aseptic technique. What does this EPA mean? The student usually recommends patient-specific procedures for health maintenance. Phases > Handovers may occur between settings (ICU to inpatient ward, inpatient to rehabilitation unit, inpatient care to outpatient primary care physician) or within settings (shift changes). Curriculum > PBMR 3: Display honesty, integrity, respect and compassion toward others. Utilizes effective, standardized approaches to care transitions reliably which contain appropriate information and anticipatory guidance during handoffs. Review of written notes, patient rounds and debriefing conversations with the team serve as sources of data to assess the ability of a student to identify and intervene in urgent/emergent situations. Does not demonstrate patient-centered skills (uses medical jargon, does not confirm patient understanding or engage the patient in decision-making, unable to read emotional cues from the patient, touches without warning), Demonstrates patient-centered skills (avoids medical jargon, insures patient understanding and shared decision-making, pays attention to the patient’s emotional response, puts patient at ease, talks before touch), Lacks judgement and self-awareness either in over or under-confidence; does not seek feedback and is defensive and/or argumentative during debriefing sessions after the procedure. EPA 10: Participate in health quality improvement initiatives. Delivers content that is level appropriate and provokes inquiry. The student considers the value of tests and procedures when recommending their use, appropriately justifying a given test or procedure using evidence-based principles. Dentistry, Medical, Education. When teaching, physicians are expected to deliver content in an engaging manner, using evidence-based learning strategies. The history is disorganized, does not contain all relevant information for the presenting concern and setting, or contains extraneous information. The student spends too much time on extraneous maneuvers. Select techniques appropriate to the complexity and acuity of the patient. Notes contain data copied from other providers without attribution or document data that was not obtained by the student. The ability to promptly recognize a patient who requires urgent or emergent care, initiate evaluation and management, and seek help is essential for all physicians. The student understands and recognizes personal limitations, emotions, and personal biases and seeks help when needed as well guidance and feedback about their performance. Search options; ... Dentistry, Medical, Education. The student may not recommend or interpret basic diagnostic tests accurately; justification for tests may be incomplete or inaccurate. SATBC-1  Describe healthcare finance and delivery in various healthcare systems, and demonstrate the ability to effectively call on system resources to provide care that is of optimal value. Engages all team members effectively and creates environment where patient safety. Suggested orders and prescriptions are justified and prioritized appropriately for the patient case, setting, and indication. • Documentation of consent contains errors. The differential diagnosis is prioritized and includes all expected diagnoses, including most likely diagnoses, and appropriate “cannot miss” diagnoses. The differential diagnosis demonstrates application of background reading, including key signs or symptoms of less common diagnoses when appropriate. PBMR 6 Demonstrate respect for privacy, protect confidentiality, and maintain security of the data of patients and families. The behaviours listed for a pre-entrustable learner identify common areas where learners often require focused coaching. All exam maneuvers relevant to the differential diagnosis are performed. EPA 8: Recognize a patient requiring urgent or emergent care, provide initial management and seek help. Documentation must be completed in a timely manner. The medical history is complete and nuanced, making clear the student’s clinical reasoning. The physical examination is performed correctly, with clear, well-timed communication with the patient and attention to patient comfort. The ability to promptly recognize a patient who requires urgent or emergent care, initiate evaluation and management, and seek help is essential for all physicians. Oral presentations demonstrate reasoning that is complete and correct even in challenging cases with justification for the prioritization of the differential diagnosis and the next steps in the diagnostic work-up and plan. What does this EPA mean? The needs of the team must supersede personal needs in order to provide best patient care. Interns are often the first responders in an acute care setting, or the first to receive notification of an abnormal lab or deterioration in a patient’s status. QUESTION What causes tooth … Fails to contribute information or speaks unclearly. Student inconsistently considers patient privacy and confidentiality (eg. after a conversation about the patient that occurs between an assessor and student after new data is collected and leads to the need to obtain or interpret additional data. The student is able to anticipate the appropriate next steps to evaluate, intervene and manage the situation in a timely manner. Demonstrates awareness of indications, contraindications, risks, benefits, and alternatives of the procedure. Physicians must appropriately recommend tests for both diagnostic and screening purposes and interpret these results. Then, as additional data becomes available—from other historical sources, exam changes, and studies—physicians must continuously revise the differential diagnosis, avoiding common errors of clinical reasoning such as premature closure. Physicians must write accurate, focused, and context-specific documentation of clinical encounters across a number of settings: office visits, admissions, daily notes, discharge summaries, phone calls, and patient email messages. EPA. The student does review information available in the chart to guide their questions. The student does not incorporate data from multiple sources, such as the medical record. Notes written in transitional care (e.g. It incorporates data from multiple sources including the medical record. Demonstrate  positive teamwork attitudes and skills during clinical care and work effectively with all members of the interprofessional team to provide best patient care. Puts needs of team ahead of personal needs. Assessment can occur any time labs and studies are being ordered or interpreted: initial discussion between a student and team resident while working up a new admission. Prescriptions are written without jargon and use standard language for frequency and dosage. The style of the presentation will be tailored to the setting to meet the needs of the receiver of the information. Interactions with the team serve as sources of data to assess the ability to work effectively with all members of the team. Written patient instructions are unclear or inaccurate. Limited participation in team discussion. The expected behaviours for the entrustable and pre-entrustable learner are outlined for each EPA. Entrustable Professional Activities (EPAs) are used as the framework for learning and assessment in Phase 4. Free text is used sparingly and only when necessary. Notes are not completed on time and/or contain inaccurate data. Listens actively and encourages ideas and opinions from other team members. The student is unable to or requires significant help advising or educating the team regarding the information obtained to answer a clinical question pertinent to patient care. PCMC 3: Display clinical reasoning skills regarding a patient case verbally and in writing. Anticipates which patients may deteriorate and why and provides appropriate steps for management. The student does not interpret or connect important pieces of information to quickly develop a differential diagnosis and plan next steps.

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