Entrustable Professional Activities for General Neurology Advanced Practice Providers: Results of a Modified Delphi Consensus Process
Daniel Harrison1, Cassie Meffert2, Elyse Doherty3, Shannon Anderson4, Jennifer Cheng5, Calli Cook6, Salvador Cruz-Flores7, John Emmett8, John Engstrom9, Miriam Freimer10, Scott Friedenberg11, Gwenn Garden12, Julia Gray13, Julie Gurwell14, Allyson Hamacher15, Jason Johns16, Keri Johnson17, Chaouki Khoury18, Alexander King17, Pearce Korb19, Ashley Lengel20, Terri Milburn6, Jamelah Morton21, Darcy O'Banion22, Victoria Pelak23, Amy Perrin Ross24, Aashit Shah25, Gretchen Tietjen26, Karen Tillotson27, Andrea Thurler28, Diego Torres-Russotto29, Juliana VanderPluym15, Brannon Vines30, Christopher Doughty31, Joel Morgenlander32
1Boston Medical Center, 2UW Health, 3Brigham and Women's Hospital, 4Oregon Health & Science University, 5Mass General Hospital, 6Emory Healthcare, 7Paul L. Foster School of Medicine Texas Tech University Health Sciences Center, 8IU Health Physicians, 9University of Calif San Francisco, 10The Ohio State University, 11Geisinger Medical Center, 12UNC-Chapel Hill Neurology, 13University of Alabama at Birmingham, 14University of Kentucky, 15Mayo Clinic, 16Dartmouth-Hitchcock Medical Center, 17University of Virginia Health, 18South Easter Center for Headaches, 19VCU Health, 20Duke University Hospital, 21Baptist Hospital, 22University of Colorado Denver, 23University of Colorado School of Medicine, 24Loyola University Medical Center, 25Carilion Clinic, 26University of Toledo, 27Geisinger Health System, 28Massachusetts General Hospital, 29Miami Neuroscience Institute - Baptist Health South Florida, 30University of Alabama Medical Center, 31Brigham and Women'S Hospital, 32Duke University Medical Center
Objective:
To define entrustable professional activities (EPAs) for general neurology APPs and to provide further validity evidence for the EPAs through application of the EQual rubric.
Background:
A dedicated didactic framework, assessment strategy, and consensus expectations for advanced practice providers (APPs) entering general neurology practice for the first time have not been described.
Design/Methods:
This was a modified Delphi consensus process. Panelists were leaders of neurology APP fellowship programs and other established experts in neurology APP education. The steering committee identified putative EPA topics. Panelists voted how important it was that a new general neurology APP be able to perform specific activities with indirect supervision remotely available by the end of their on-the-job training. Panelists proposed modifications to putative EPAs and suggested new EPAs. After three rounds of voting, full EPA descriptions were drafted then assessed by external experts in neurology APP education. The steering committee made adjustments based upon this feedback. The full EPA descriptions were sent to the Delphi panelists for a final round of voting.
Results:
Of 35 experts invited to participate in the Delphi process, 30 agreed to serve as panelists, 16 of whom were leaders in neurology APP fellowship programs. The steering committee proposed 13 core and 52 nested EPA topics and the panelists proposed 6 modifications and an additional 4 nested EPAs. After 3 rounds of voting, 13 core and 46 nested EPAs were retained and full EPA descriptions were authored. All EPA descriptions met the pre-specified cut score for quality and structure and were retained in a final Delphi round. Overall entrustment expectations did not differ between panelists who were fellowship program leaders and those who were not (5 point Likert median [IQR], 4 [4-5] vs 4 [4-5], p= 0.980).
Conclusions:
These consensus EPAs may be applied for curricular development and assessment for new general neurology APPs.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.