Gersten Jonker

A better transition with the ACTY   107 5 team created three ACTY EPAs: ‘Recognition and initial treatment of patients with vital instability’, ‘Evaluation and initial treatment of patients with respiratory insufficiency’, and ‘Evaluation and initial treatment of patients with circulatory insufficiency’ (See Chapter 2 for full descriptions). In monthly three-hour teaching sessions, all ACTY students and teachers discuss acute care content related to the EPAs. We designed these sessions to foster a learning community of highly motivated, congenial peers [24]. The sessions present a forum for teacher-guided peer reflections on clinical situations students experienced. Students commencing the ACTY take an extensive multimodal formative pre-test blueprinted to the ACTY EPAs, to assess knowledge, clinical reasoning, skills, and performance in high-fidelity simulations. The test is designed as a motivating and eye- opening starter to set the stage for the final year, to identify both existing strengths and areas for improvement, and to guide personal learning during the subsequent clinical rotations [24, 25]. ACTY students choose three out of five participating specialties for one sub-internship of twelveweeks and two of sixweeks. Additionally, students take a twelve-week research elective in one of the five ACTY specialties. At completion of the ACTY, students take a formative post-test, similar to the pre-test, to identify the degree of personal growth, provide insight in acute care competence, and detect areas for further learning. The test is mandatory, but not created to serve as a pass/fail assessment. The ACTY provides orientation on a career within the acute care domain. The ACTY targets the sweet spot between breadth and depth in a final year. Breadth is essential to deliver broadly trained physicians; depth is vital for individualization and pre- specialization. The track offers concentrated but balanced clinical experience, without being overly focused or narrowed down to a single specialty [26]. The ACTY aims to equip graduates with acute care competence, useful for doctors aspiring a career in the ACTY specialties and in other fields. Simultaneously, the year allows students to discover which specialty within the acute care domain best matches their interests, while educators can gauge the fit of a student within the specialty. Specialty orientation is a worthwhile goal. One third of students make their choice in the final year and the majority indicate that final year experiences have a strong influence on their ultimate choice of specialty [27]. All ACTY students are assigned to a senior postgraduate trainee