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Cognitive and Psychomotor Entrustable Professional Activities: Can Simulators Help Assess Competency in Trainees?
Tim Dwyer1, Veronica Wadey2, Douglas Archibald3
1Women's College and Mt Sinai Hospital, University of Toronto, 76 Grenville Street, Toronto, M5S 1B1, ON, Canada. tim.dwyer@wchospital.ca.
Clinical Orthopaedics and Related Research
|September 24, 2015
Summary
Simulation-based assessment reliably evaluates resident performance of entrustable professional activities. Senior residents (PGY-4) demonstrate superior skills compared to junior residents (PGY-1) in simulated surgical scenarios.
Area of Science:
- Medical Education
- Surgical Training
- Simulation-based Assessment
Background:
- Entrustable Professional Activities (EPAs) are crucial for postgraduate resident mastery.
- The efficacy of simulation for assessing EPA performance requires further validation.
Purpose of the Study:
- To determine the reliability of simulation-based assessment for resident EPAs.
- To investigate performance differences between PGY-1 and PGY-4 residents in simulated EPAs.
Main Methods:
- Three EPAs (hip fracture, ankle fracture, total knee arthroplasty) were simulated.
- Assessments included preoperative, technical (sawbones model), and postoperative management.
- Residents were evaluated by faculty using checklists and global rating scales.
Main Results:
- High reliability (Cronbach's α: 0.84-0.89) and interrater agreement (0.87) were observed.
- PGY-4 residents significantly outperformed PGY-1 residents in most EPA components.
- Specific differences favoring PGY-4 residents were noted in preoperative, postoperative, and technical skills for hip fracture and TKA.
Conclusions:
- Simulation-based assessment is a valid method for evaluating resident competence in EPAs.
- This approach ensures skill proficiency in a simulated environment before patient care.
