Paediatric Primary Care Postgraduate Training using Entrustable Professional Activities with PaedCompenda

Background: There is an absence of broad-based and binding curricular requirements for structured competency-based post-graduate medical training. There is no basis for comparing the competencies of physicians undergoing paediatric training. This can be ameliorated by bringing back trust in the equation of learners, health care staff, patients and society.

Objective: Phases during medical training dedicated to primary care should be integrated into formal medical specialty training. Primary care paediatrics must develop the sites where such training takes place into learning environments. There physicians trainees get their practical education and the practicing specialists turn into mentoring educators.

Methods: The working group on post-graduate education of the German Society of Primary Care Paediatrics(DGAAP) has identified realistic entrustable professional activities (EPAs) in primary care, defined their number, scope and content, selected competency domains, specified required knowledge and skills, and described appropriate assessment methods. 200 residents in primary care paediatrics are using the online tool www.paedcompenda.de

Results: Core competencies have been identified. Alongside treating preventable courses of disease, the focus on the DGAAP’s EPA curriculum is prevention and long-term care of chronically ill children in Primary Paediatric Care. Based on the preliminary groundwork, 12 EPAs were identified and assigned to learning objectives. Assessment formats were also compiled. Each EPA begins with a description in which the sub-competencies are clearly listed. A matrix ensures that all sub-competencies in the curriculum are covered and shows the frequency of the individual sub-competencies.

Conclusion: The introduction of competency-based post-licensure training into primary care paediatrics has been met with both enthusiasm and reservation. Advocates see a great potential for trust in a network of physician trainees, physician mentors, children and families, and society at large. Critics see substantial amounts of extra work, bureaucracy, and the movement of sought-after physician trainees from hospitals into primary care.