Development of a nutrition Entrustable Professional Activity for pediatric residents

Objective Describe the process of developing a nutrition Enstrustable Professional Activity (EPA) for pediatric residents in the Boston Combined Residency Program (Boston Medical Center and Boston Children's Hospital). Introduction The top three causes of mortality in the United States are nutrition‐related and preventable. Unfortunately, most physicians feel unprepared to address nutrition‐related conditions, even those that are common in pediatric practice. The American Association of Medical Colleges (AAMC) has developed an educational framework that includes competencies (physician descriptors) and EPA (work descriptors) to train and assess residents, which can be used to support inter‐professional medical residents training in nutrition, metabolism, and lifestyle behaviors. Methods After establishing the need for improved nutrition training for residents, a meeting was scheduled with residency educators to write a proposal to improve residency training in pediatric nutrition in February 2014. Funding was obtained in December 2014. EPA were defined as an important method to improve resident training in nutrition. A multidisciplinary group of health care professionals was identified and composed of registered dietitians, physician educators, a pediatric resident, and a physician nutrition specialist. We used the approached described in Cate (2013) to guide our creation of a full EPA description. A focus group approach rather than a Delphi method approach was used in meetings. Several face‐to‐face and telephonic meetings, with later work being done individually and reviewed by the group until completion of the EPA. Results The group identified the five major components that needed to be addressed to create a pediatric nutrition EPA: (1) Target resident population, (2) Target patient population, (3) Target location of care, (4) EPA structure and presentation, and (5) Logistics. Challenges during development included defining the scope of the EPA, appreciating and properly balancing the content requirements with the limitations of the EPA structure, and potential barriers to implementing an EPA in practice. The end result of this process was the development of the first nutrition EPA for pediatrics, titled, “manage pediatric nutrition in the ambulatory setting.” Discussion The creation of the EPA was the first step in establishing nutrition as an entrustable professional activity for residents. This is the first EPA for pediatric residents focused primarily on nutrition. The development of an EPA is a complicated process that requires a team with sufficient and varied expertise, and adequate resources are needed for its implementation. Support or Funding Information Support from New Balance Foundation