Gersten Jonker

40   Chapter 2 Assessment EPAs and their assessment are used to focus experiential learning during the clinical placements. Students take a multimodal exam, blueprinted to the three EPAs, at the start and at the end of the ACTY. This exam consists of several parts that test knowledge (written, closed and open format questioning), skills (several stations with Objective Structured Clinical Examinations), clinical reasoning (case-based discussions), and clinical performance in high-fidelity simulations of acute care settings. The pre-test focuses the students’ minds on the learning objectives and the expected performance level. The post-test, being similar to the pre-test, assesses the students personal development in competence. Workplace-based assessment in the ACTY is aligned with the EPAs. Short practice observations were developed collaboratively by the ACTY team to cover observable units that are part of the EPAs (e.g. ‘Take a focused history of a dyspneic patient’, Table 4). These specific short practice observations are additional to the existing general ones in use in the master phase of medical school at UMC Utrecht and draw the attention of student and supervisor to the learning objectives of the ACTY. Students document their practice observations in a paper-based portfolio, soon to be superseded by an electronic version. Up until now, formal entrustment decisions on EPAs have not yet been part of summative evaluations of ACTY students. Longitudinal support The student is matched with one mentor for the entire year. The mentor is a senior resident in one of the participating specialties. This ‘buddy’ offers longitudinal developmental student support [15], serves as a role model, may assist in acculturation to the specialty, in career planning, in applying for residency, and in making most of the rotations [5, 6]. Mentors do not have a role in formal assessments of the mentee. Anecdotally, this mentorship is appreciated highly by both mentees and mentors. Another special feature of the ACTY is the monthly academic half-day. This is an interactive small group teaching session meant to exchange experiences of students and to discuss EPA-related topics from an integrative multidisciplinary viewpoint. In exit interviews, students report that it also fosters the motivating sense of belonging to a group, or class, whereas the usual transitional year in our medical school is purely individualistic. Our yearlong spaced-learning cycle of academic half-days covers the contents of intensive capstone bootcamp courses that are commonly employed in the transition to residency in the United States [7, 16].