Gersten Jonker

Delivery and adoption of the ACTY   55 3 Many supervisors put effort in enabling students to reach ACTY learning objectives by advising which learning activities to pursue or altering their placement: Basically, the rotation looks the same, but based on the goals of the student, I try to facilitate the student to reach those objectives; for example by placing them in the Emergency Room, or not. (Su30) Most students used the three ACTY EPAs in clarifying the learning objectives for their rotations. Students usually made their learning objectives a topic in the conversation with their supervisor at the start of their rotations. Students said that the EPAs focused their learning process during the rotations. By the end of the year, I want to master those EPAs, and that’s what I’m working on. And, you know, without those objectives I would have just done the rotation and it would have been okay to semi-master them, but now I’m keen on fully mastering them. (St22) Most supervisors were aware of the EPAs and many found the EPAs to provide a good overview of the expected level of competence at graduation and they appreciated the transdisciplinary nature of the EPAs: Because of this specific setting of rotations that are connected and aligned within a theme, students are better prepared to work in all these specialties. (Su15) Some supervisors viewed the EPAs as ambitious and perhaps unfeasible for students in practice. Although students deemed the expected performance level of the EPAs realistic and appropriate, they faced limited possibilities to get hands-on clinical experience in these acute care professional activities. Students advisedmaking the EPAs better known to staff to improve supervision and involvement, which would extend possibilities to gain hands-on experience. Students felt that, instead of global rotation evaluations, explicitly making the entrustment decision the focus of assessment would reinforce the role of EPAs in the workplace. I think you’d be more focused if you know that goal in advance. You have those EPAs and you want to get a pass mark on them, so you pay more attention to them. (St33) Some students doubted whether entrustment decisions would lead to decrease of supervision, given that residents usually perform these acute care activities.