Program Director Perceptions of Proficiency in the Core Entrustable Professional Activities.

Area of Science:

• Medical Education
• Graduate Medical Training
• Professional Competency Assessment

Background:

• The Association of American Medical Colleges outlined 13 core entrustable professional activities (EPAs) for graduating medical students.
• Variability exists in program director (PD) confidence regarding intern EPA proficiency.
• The relationship between United States Medical Licensing Examination (USMLE) scores and EPA proficiency is not well-established.

Purpose of the Study:

• To assess PD confidence in postgraduate year 1 residents' ability to perform core EPAs.
• To compare perceived EPA proficiency with USMLE Step 1 and Step 2 scores within a large health system.

Main Methods:

• Program directors rated resident proficiency across 13 core EPAs.
• Resident USMLE Step 1 and Step 2 scores were collected.
• Data collection coincided with resident milestone reporting periods.

Main Results:

• PDs reported significant percentages of residents unprepared for key EPAs, including order writing (EPA 4), forming clinical questions (EPA 7), handovers (EPA 8), informed consent (EPA 11), and patient safety (EPA 13).
• A negative correlation was observed between EPA ratings and USMLE Step 1 and 2 scores (r(101) = -0.23, P = .031).

Conclusions:

• A notable proportion of residents were perceived by PDs as inadequately prepared in critical areas like order writing, clinical question formulation, patient handoffs, informed consent, and patient safety.
• No positive association was found between USMLE examination scores and resident EPA proficiency ratings.