(67 - Saturday) Creating a Standardized Assessment Tool for Pediatric Cardiac Critical Care Fellows: Mapping and Integrating Entrustable Professional Activities and Consensus-Based Curriculum Guidelines

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Abstract: Introduction/

Objective: The field of pediatric cardiac critical care is unique in that all trainees do not come from a common pathway of categorical training. The heterogeneous training pathways include pediatric cardiology, pediatric critical care, anesthesiology, neonatology, or surgery and this diversity is vulnerable to inconsistent educational standards. For this reason, two separate working groups have previously developed common curricular recommendations (Tabbutt et al) and entrustable professional activities (EPAs) (Werho et al) that can be applied to all trainees regardless of training taxonomy. However, these curricular recommendations and EPAs have not yet been fully mapped to individual competencies and skills nor integrated into training programs and trainee assessment methods. Thus, we aim to create and implement a comprehensive EPA-based framework for a standardized assessment tool in pediatric cardiac critical care.

Methods: Four content experts developed a multi-step process map for creating and implementing a standardized assessment tool. Step 1 includes: 1) mapping curricular and competency components to EPAs using previously published common curriculum recommendations and adapting the American Board of Pediatrics EPAs for pediatric cardiology and pediatric critical care, 2) creating anchored levels of entrustment, and 3) identifying examples of simple and complex cases for each EPA. Step 2 includes consensus building of the mapped EPAs using modified Delphi methodology with a working group of 10 program directors from pediatric cardiac critical care advanced fellowships in the United States. A pre-defined level of >80% agreement was required for consensus. Step 3 includes: 1) integrating the components of the consensus-based EPAs into an online assessment tool on a REDCap platform with the ability for programs to host their own fellows' data locally, 2) developing a mobile-friendly platform that utilizes individualized trainee QR codes for real-time assessments, and 3) pooling and synthesizing trainee reports for the clinical competency committee at each respective program.

Results: A multi-step process map for implementing standardized assessments for pediatric cardiac critical care trainees was developed. The nine EPAs for pediatric cardiac critical care were mapped to the curricular guidelines and competencies with anchored levels of entrustment and examples of simple and complex cases as depicted in Figure 1. Consensus was achieved by the working group of 10 program directors.

Conclusions: We created a process that mapped recommended curricular elements and EPAs for pediatric cardiac critical care medicine for use in a standardized assessment tool, which can be implemented into training programs. Next steps include integration of the EPAs into an online assessment tool, development of a mobile-friendly platform, and validation of the tool across various learner and program types.