Developing Entrustable Professional Activities as the Basis for Assessment of Competence in an Internal Medicine Residency: A Feasibility Study
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Graduate medical education programs assess trainees’ performance to determine readiness for unsupervised practice. Entrustable professional activities (EPAs) are a novel approach for assessing performance of core professional tasks.
To describe a pilot and feasibility evaluation of two EPAs for competency-based assessment in internal medicine (IM) residency.
Post-graduate year-1 interns (PGY-1s) and attendings at a large internal medicine (IM) residency program.
Two Entrustable professional activities (EPA) assessments (Discharge, Family Meeting) were piloted.
PROGRAM FEASIBILITY EVALUATION
Twenty-eight out of 43 (65.1 %) PGY-1 s and 32/43 (74.4 %) attendings completed surveys about the Discharge EPA experience. Most who completed the EPA assessment (10/12, 83.8 %, PGY-1s; 9/11, 83.3 %, attendings) agreed it facilitated useful feedback discussions. For the Family Meeting EPA, 16/26 (61.5 %) PGY-1s completed surveys, and most who participated (9/12 PGY1s, 75 %) reported it improved attention to family meeting education, although only half recommended continuing the EPA assessment.
From piloting two EPA assessments in a large IM residency, we recognized our reminder systems and time dedicated for completing EPA requirements as inadequate. Collaboration around patient safety and palliative care with relevant clinical services has enhanced implementation and buy-in. We will evaluate how well EPA-based assessment serves the intended purpose of capturing trainees’ trustworthiness to conduct activities unsupervised.
KEY WORDSclinical competence assessment education medical graduate medical education
The authors thank William Iobst, MD, and Kelly Caverzagie, MD for sharing their expertise at our planning retreats, Sue Sheehan for administrative support, and Joanne Batt for data management.
Dr. Hauer received support from the American Board of Internal Medicine. There was no additional funding specific to this project.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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