Table 2.
Overview about the defined EPAs with required key knowledge, skills and attitudes required
| Knowledge | Skills | Attitude |
|---|---|---|
| EPA 1: Non-operative management of patients with a brain tumour diagnosis | ||
| Knowledge about the neuropathology of brain tumours | Adequate communication and collaboration | |
| Diagnostic work-up and interdisciplinary treatment | Advising patients and their families | Considering the patient´s wishes |
| Consideration of common differential diagnoses | Management of critically ill patients | Prioritization of urgent medical issues |
| Coordination of interdisciplinary and interprofessional assessments | Recognition of own limitations | |
| EPA 2: tumour-based resection | ||
| Expertise of anatomy of the brain | Adequate and appropriate communication/cooperation | |
| Knowledge about the neuropathology/techniques for tumour removal | Correct indication of surgery balancing risks and benefits | Recognition of own limitations and willingness to seek for help |
| Awareness of different surgical goals | Mastering all required surgical techniques in a safe and efficient manner | Prioritization of urgent medical issues |
| Expertise in surgical techniques | Use of techniques for intraoperative localisation of tumour boundaries | Adherence to established institutional safety protocols |
| Awareness of different anaesthetic techniques | ||
| EPA 3: function-based surgical resection of brain tumours | ||
| Expertise of anatomy of the brain | Adequate and appropriate communication/cooperation | |
| Knowledge about the neuropathology and techniques for tumour removal | Adequate selection and planning of preoperative investigations risks and benefits | Create a constructive a motivating relationship with the patients |
| Knowledge about intraoperative monitoring and intraoperative neurological testing | Choosing a suitable surgical procedures fe and efficient manner | Respect for and adherence to established procedures and institutional safety protocols |
| Expertise in surgical techniques | Apply and correctly interpret intraoperative monitoring | |
| Awareness of different anaesthetic techniques | Indicate, prepare and master awake surgeries | |
| Balance the targeted extent of resection to the functional risks | Effective management of limitations and complications | |
| EPA 4: postoperative management of brain tumour patients | ||
| Knowledge about the neuropathology molecular markers | Adequate and appropriate communication/cooperation | |
| Knowledge about signs, symptoms and management of complications | Systematic approach to patient assessment and therapy | Create a constructive a motivating relationship with the patients |
| Diagnostic work-up and inter-disciplinary treatment of patients | Evaluation of post-operative imaging | Respect for and adherence to established procedures and institutional safety protocols |
| Knowledge about multimodal treatment plans and radiation oncology treatment methods | Coordination of interdisciplinary treatment plans | |
| Consideration of common differential diagnoses of postoperative neurological deterioration | Delivering bad news appropriately (resource- activating, supportive) | |
| Postoperative imaging of brain tumour patients | Advising patients and their families | |
| EPA 5: management of deteriorating brain tumour patients | ||
| Recognise red flags and emergencies | Clear, concise and structured communication | |
| Consider common differential diagnoses | Systematic approach to patient assessment and therapy | Usage of an appropriate level of urgency for further management |
| Initiate time-critical further monitoring, assessment and therapy | Skills in emergency medicine and neuro-oncological surgery | Recognition of own limitations and when to seek for help |
| Adequate judgement on the need of an implementation of further therapy | Prioritization of urgent medical issues | |
| Clear, concise and structured communication | Calm demeanour | |
| EPA 6: early palliative care for dying patients and their families | ||
| Treatment of symptoms and suffering on four symptom levels | Adequate and appropriate communication/cooperation | |
| Knowledge about palliative anti-tumour therapies | Advising patients and their relatives | Cooperation in a (multi-professional) team and constructive teamwork |
| Recognize physical signs and symptoms of dying patients | Delivering bad news appropriately, taking a conversation model into account | Appreciating the importance and time sensitivity in treating palliative humans |
| Criteria for when to start palliative care (e.g. early integration) | Coordinating interdisciplinary and interprofessional assessments | Establish ethical principles and apply them to end-of-life care |
| knowledge about palliative care structures | Recognizing dying patients and treating them within standardized procedures | |
| EPA 7: collaboration as a member of an interdisciplinary and/or -professional neuro-oncology team | ||
| Factors that affect teamwork and effective communication | Actively strives to integrate into the team | Feels committed to the goal of the team and optimal patient care |
| Strategies for safe communication | Adequate and appropriate communication | Prioritizes an optimal patient care and team needs over personal needs |
| Establishes a climate of respect, appreciation, integrity, and trust | Recognizes the role, responsibilities, contributions and value of all team members | |
| Offers help to members of the team in need | ||
| Includes and attentively listens to team members and considers feedback | ||
| EPA 8: basic and clinical research activity in neuro-oncology | ||
| Understanding of the main scientific challenges in Neuro-Oncology | Perform a literature review based on scientific libraries | Establish ethical principles and apply them in research |
| knowledge about basic research methods and approaches | Translate problems into precise scientific questions | Knowledge, respect of and adherence to established ethical protocols |
| knowledge about statistical analysis and interpretation of data | Compile, analyse und interpret clinical and experimental data sets | Respect of and adherence to national and international law |
| Preparing/etting up a clinical trial | ||
| Prepare scientific results for a specialist audience | ||
Table 2 gives an overview about the defined EPAs with key knowledge, skills and attitudes for each EPA. A detailed definition of each EPAs including a specification, a definition of all required knowledge, skills and attitudes and recommended potential assessment tools to evaluate progress and proficiency are provided in supplement
IOM intraoperative neurophysiological monitoring