Gersten Jonker

The ACTY: acute care transitional year   33 2 may progress towards the center with growing experience [13]. The main learning objectives of the ACTY are three EPAs that comprise relevant authentic tasks for starting residents covering ‘common ground’ of the five participating specialties: ‘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’ (Table 1-3). The three EPAs designate underpinning competencies, required knowledge, skills, and attitudes (c.f. [12]). The aim is to train students towards the level of performing these activities with indirect supervision (with post hoc review), which befits the level of responsibility that residents in their first year of training must take on [4, 10]. This set of three EPAs drives learning, teaching, and assessment in the entire ACTY. The ACTYEPAsweredeveloped iterativelyandcollaborativelybyexperiencedundergraduate and postgraduate faculty (n=13) of the involved departments. The developmental process took place between September 2014 and June 2015 and consisted of several meetings, separated and followed by iterative rounds of developing concept EPAs by email. Consensus was reached on the final product by all involved faculty members. The ACTY EPAs are meant to align student training objectives with postgraduate expectations [10] and are special for not being confined to a single specialty, and thus transcend traditional barriers in being activities that are relevant for several specialties. Core EPAs versus ACTY EPAs During their rotations students are exposed to the breadth of the specialties they have chosen. In their work in emergency medicine, for example, they encounter patients with fractures, in anesthesiology they learn basics of providing anesthesia, in cardiology or pulmonary medicine they see patients with chronic disease. These aspects of their work are not part of the three ACTY EPAs per se. The EPAs deal with the shared interest of the participating specialties in recognition and initial treatment of acutely compromised patients. However, work that is not confined to the EPAs is valuable in containing part- tasks that are useful experience for the EPAs (e.g. interpreting an ECG) and provides understanding of what the specialty encompasses. The development of the ACTY EPAs preceded the development of core EPAs for medical school at UMC Utrecht, a process that is currently underway. Core EPAs will provide scaffolding for learning of all students during the clinical phase, with the ACTY EPAs providing advanced level objectives for the students choosing the ACTY. The ACTY EPAs intend to focus the attention of the student on these tasks during clinical placements that traditionally had no explicit learning objectives.