Transition to Practice

  • Key Features

    • This EPA focuses on the independent management of an inpatient service in the role of the physician most responsible for patient care. Building on the competencies of the Core stage, this includes application of the knowledge, skills and attitudes expected of an independently practicing physician.

    • This includes responsibility for the overall safe quality care of acute and chronic patients, working effectively with the interprofessional team, completing administrative tasks, bed management, and supervising, coaching, assessing and providing feedback for junior learners.

    • The observation of this EPA is divided into two parts: patient care; interprofessional interaction/supervision.

    • The patient care aspects of this EPA are based on at least one week of observation caring for a patient population that is reflective of a general pediatric practice in the local context.

    Assessment Plan

    • Direct and indirect observation by supervisor

    Collect 3 observations of achievement

    • At least 1 case load of high complexity

    • 2 different supervisors

  • Key Features

    • This EPA focuses on the resuscitation and stabilization of critically ill pediatric patients of all ages.

    • This EPA includes identifying priorities for management and the need for intensivist and/or other specialist support.

    • It includes participating in a debrief session after the acute event.

    • This EPA does not include ongoing inpatient management of acutely ill pediatric patients.

    • This EPA may be observed in the simulation setting.

    Assessment Plan

    • Feedback from multiple observers compiled by supervising pediatrician

    Collect feedback from at least 3 observers on one occasion during Transition to Practice

  • Key Features

    • This EPA focuses on the longitudinal management of a general pediatric outpatient clinic in the role of the physician most responsible for patient care.

    • This includes responsibility for medical care decisions, time and caseload management, follow-up on investigations and accessibility in between clinic visits.

    • The observation of this EPA is not based on a single patient encounter, but rather on the resident performance over a period of time.

    Assessment Plan

    • Direct and/or indirect observation by supervisor(s), with input from nurse, clerk +/- other health care professionals

    Collect observations at 1-3 months intervals with at least 2 observations of achievement

  • Key Features

    • This EPA focuses on the application of communication skills to lead discussions with patients and families about progression of illness and evolution of the goals of care.

    • This includes patients with complex medical issues and/or life-limiting conditions for whom decisions regarding goals of care may impact plans for management.

    • This EPA includes the legal and ethical aspects of these discussions and decisions.

    • It may also include providing referral to resources to support ongoing patient care and/or bereavement resources for the family.

    • This EPA may be observed in simulation.

    Assessment Plan

    • Direct observation by supervisor

    Collect 2 observations of achievement

    • No more than 1 in simulation

  • Key Features

    • This EPA focuses on leading meetings for the purposes of discussing clinical status and management, clarifying patient/family expectations, setting treatment goals, reviewing patient progress and/or discharge planning.

    • This includes leading the discussion, attending to meeting flow and organization, encouraging participation from all members, integrating information from the interprofessional team, promoting patient-centred goal-setting, and facilitating discharge planning.

    • This EPA includes identifying and managing conflict between patients, families, other physicians, and other health care providers, as well as complex communication scenarios such as those needing the use of an interpreter.

    Assessment Plan

    • Direct and/or indirect observation by supervisor, with input from others

    Collect 4 observations of achievement

    • ­At least 2 of each meeting type

    • At least 1 direct observation by a supervising pediatrician

  • Key Features

    • This EPA includes the review and analysis of a patient safety event and identification of the human, system and other factors leading to the event.

    • This includes a review of expected standards or outcomes of health care delivery, analysis of the reasons for the gap in desired outcome, and may include suggestions for potential improvement.

    • The observation of this EPA requires that the resident participates in the analysis but it is not necessary for the resident to implement or participate in the implementation of any changes.

    • This EPA may be observed via presentation of findings (e.g., at rounds or to a committee) or via submission of a report.

    • This EPA may be observed using a simulated patient safety case.

    Assessment Plan

    • Direct observation of case presentation by supervisor

    Collect 1 observation of achievement