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Core Entrustable Professional Activities: a Survey of the Confidence of Fourth-Year Medical Students and Residency Program Directors

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In 2014, the Association of American Medical Colleges published 13 Core Entrustable Professional Activities (EPAs) that all medical school graduates should be able to perform on the first day of residency without direct supervision. We undertook a study to determine the confidence level of graduating students at one US medical school in performing the core EPAs and to compare the students’ confidence levels with those of the same institution’s residency program directors (PDs). Understanding differences between intern confidence and PD expectation will allow PDs to be better informed about the educational needs of their early trainees.


168 of 323 graduating medical students (52 %) in the classes of 2014 and 2015 completed surveys indicating their confidence in accomplishing each EPA using a five-point Likert scale. Twelve residency PDs who train interns completed similar surveys.


Students were generally confident in their abilities. They were most confident in their ability to take a history and perform a physical examination and least confident in performing procedures. There was general agreement in confidence levels between students and PDs across most EPAs. An important difference was in the ability to perform handoffs, with student ratings lower than those of PDs.


Graduating medical students and residency PDs are generally confident that new interns can perform the 13 core EPAs without supervision, although levels of confidence vary by activity. These results can guide future studies on how to incorporate the EPAs into medical school and residency training, especially in areas with lower confidence.

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The manuscript was copyedited by Linda J. Kesselring, MS, ELS, the technical editor/writer in the Department of Emergency Medicine at the University of Maryland School of Medicine.

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Correspondence to Laura J. Bontempo.

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Frayha, N., Bontempo, L.J., Retener, N.F. et al. Core Entrustable Professional Activities: a Survey of the Confidence of Fourth-Year Medical Students and Residency Program Directors. Med.Sci.Educ. 26, 475–480 (2016).

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