Gersten Jonker

The ACTY: acute care transitional year   39 2 TABLE 3: Continued Title Evaluation and initial treatment of patients with circulatory insufficiency Systematic interpretation of chest X-ray and recognition of relevant radiologic findings; Sites a peripheral intravenous catheter; Drafts and ranks a differential diagnosis and provides a probable diagnosis in a patient with circulatory insufficiency; Proposes a management plan; Proposes orders regarding treatment; Reports in medical record and provides a structured handover. Attitudes Discerns and acknowledges personal limits of knowledge, skill and capability and can adequately reflect on this; Is set to short cycles of assessment, treatment, and re-assessment; Reveals professional role and level; Collaborates with ward staff; Professional conduct towards patient and/or relatives; Uses Evidence Based Medicine. Information to assess progress Workplace assessment Mini-CEXs with regard to the evaluation of patients with or without vital instability, including indicating necessity for (acute) intervention and with regard to discernment of personal limits of capability; Multisource feedback: performance as a team member in urgent and non-urgent settings; Assessment of knowledge, skills and attitudes Knowledge examination (written, variety of formats); Clinical reasoning and know-how (case-based discussions); Demonstration of isolated skills in non-clinical setting (Objective Structured Examination of Clinical Skills); Reflection forms regarding performance, difficult moments, discernment of limitations. Assessment of clinical performance Simulation of acute care settings. Target level of supervision (entrustment) Indirect supervision (immediately available): evaluation and initial management, awaiting arrival of help/supervisor When is unsupervised practice expected? At completion of the ACTY So, the ACTY EPAs can be seen as elective undergraduate EPAs [7], beingmore advanced than the core EPAs for entering residency that every medical graduate must master [10]. The EPAs can be linked to broader and more complex EPAs of postgraduate training in the participating specialties [9, 10], adding to the educational continuum in medical training. Currently, the EPA concept is being widely embraced in postgraduate medical training in the Netherlands [14].