Appendix 1: EPA Multiple trauma patient

EPA-description

An Entrustable Professional Activity (EPA) (a) is an identifiable part of clinical work in the local context, (b) requires a specific level of knowledge, skills and attitude, (c) is part of regular work of the medical specialty, (d) reflects one or more items from the CanMeds competency framework (e) can be performed separately from other tasks, (f) can be executed within a limited timeframe, (g) can be observed and assessed.

Title EPA Resuscitation of the multiple trauma patient in the Emergency Room

Detailed description Resuscitation of trauma patients, of all age groups, in the (including limitation of the Emergency Room. Active participation in the trauma team. EPA to specific patient Assessment and control of vital organ systems. Pain groups and/or context) management in trauma patients.

Which specific 1. Trauma mechanisms & pathophysiology knowledge, skills and 2. Organization of trauma care attitudes are necessary to 3. Collaboration in the trauma team perform the EPA at an 4. Trauma diagnoses & treatment adequate level? 5. Primary & secondary survey 6. Trauma airway management 7. Emergency IV1 & IO2 access 8. Emergency thoracostomy 9. Haemorrhage / massive transfusion 10. Emergency Room registration procedures

Which CanMEDs Ø Medical expert competency fields are Ø Communicator mostly addressed in this Ø Collaborator EPA? Ο Manager Ο Scholar Ο Health advocate Ø Professional How can progression of the 1. Trauma Mini-CEX3 resident in this EPA be 2. OSATS4 on trauma airway management assessed? 3. OSATS on emergency IV & IO access 4. OSATS on emergency thoracostomy 5. Multi-source feedback 6. Trauma case-based discussions 7. Participation in trauma Simulator Sessions

Which criteria must be met 1. Completion of two-month rotation Anesthesia in the by the resident to fulfil Emergency Room the EPA satisfactory 2. ATLS5 certification with 3. APLS6 certification proficiency level IV 4. Positive result (pass) on (at least) five trauma Mini- (resident may act with CEX, on different days, by different assessors in postponed or different contexts backstage supervision) 5. Positive result (pass) on (at least) two case-based discussions on trauma, on different days, by different assessors in different contexts 6. Positive result (pass) on OSATS on trauma airway management, emergency IV & IO access and emergency thoracostomy 7. Positive result (pass) on two trauma Simulator Sessions, in different contexts 8. Positive result (pass) on the evaluation of the EPA by (at least) 3 different assessors

1. IV = Intra Venous 2. IO = Intra Osseous 3. Mini-CEX = Mini Clinical Evaluation Exercise 4. OSATS = Objective Structured Assessment of Technical Skills 5. ATLS = Advanced Trauma Life Support ® 6. APLS = Advanced Pediatric Life Support ®