Gersten Jonker

32   Chapter 2 PROJECT DESCRIPTION A multidisciplinary thematic dedicated transitional year The departments of anesthesiology, cardiology, emergency medicine, intensive care medicine and respiratory medicine at the UMC Utrecht, and St. Antonius Hospital, Nieuwegein, the Netherlands, have collaboratively developed a multidisciplinary thematic dedicated transitional year (DTY). The theme of our DTY is recognition and initial treatment of acutely compromised patients (therefore named Acute Care Transitional Year, ACTY). This is an important facet of all five participating disciplines, which combine an analytic approach with an interventional mind-set. At UMC Utrecht, students may elect to pursue our particular DTY. The twelve week research placement is chosen in one of the five involved specialties. The student chooses clinical rotations in three different specialties out of five partaking in the ACTY. One placement is twelve weeks and two placements are six weeks each. This composition allows the student to gain concentrated but balanced clinical experience in areas of their interest, without being overly specialty-focused [5]. During the clinical rotations the students work at near-intern level to get accustomed to the roles and responsibilities of a resident [4, 5, 8]. This means that students get assigned identical tasks to those of junior residents, essential items are checked by supervisors, and prescriptions suggested by students need to be ratified by a physician. Together with a six-week common introductory block, holidays and a six-week closing block, the transitional year completely covers the final year in medical school. Learning objectives: Entrustable Professional Activities Because the ACTY aims to facilitate the transition to residency, clinical tasks that starting residents must perform are suitable learning objectives [1, 9, 10]. Using tasks as learning objectives offers structure and clarity in the chaotic educational context of clinical practice [11]. It fosters learning by creating commitment and motivation [11]. Learning objectives, pertaining to clinical tasks, may be formulated as entrustable professional activities [1, 9, 10]. An entrustable professional activity (EPA) is a separately executable unit of clinical work, which can be performed with decreasing levels of supervision, and which may be entrusted to an individual that has been deliberately declared competent to execute that task without direct supervision [12]. The concept of EPAs fits well in the theoretical frameworks of Community of practice and Situated learning [13], which emphasize the importance of authentic tasks in (apprenticeship) learning. By being engaged in small but meaningful real world tasks, even novice learners may participate legitimately at the periphery of a community of practice and