EPAs and Milestones in teaching and assessment
As disciplines transition to CBD, educators will use EPAs and milestones to design educational activities and teach specific abilities. Once the skills and attitudes of individual milestones have been learned, supervisors can assess the achievement of various milestones in an integrated, authentic manner by observing the performance of an EPA.
Overtime, frequent observations and “small stakes” assessments of learners by multiple observers will provide a comprehensive image of a trainee’s competence and inform promotion decisions.
Milestones and EPAs — where do you fit in? The front office or the back office?
As CBD rolls out across Canada, program directors, competency-based medical education (CBME) leads and professionals in postgraduate medical education offices will introduce important new educational concepts to residents and clinical teachers. If you wear one of these educational leadership hats, you will need a deeper exposure and understanding of these new concepts compared to some of your colleagues. The truth is that not every front-line physician needs to know the intricate ins and outs of EPAs and milestones. However, those of you with a “back office” role (e.g., program directors, CBME leads) require a deeper understanding so that you can make essential program changes and build resident and clinical teacher capacity to implement CBD.
However, when a supervising physician feels a resident is not performing at the right level, referring to the EPAs and their milestones can help guide corrective action and advice.
- Tools and resources
- Video: Milestones and EPAs in the Royal College CBD Model
- Understanding milestones and EPAs (Dialogue, Feb. 2015)
- CanMEDS Milestones Guide
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