Measuring Competence in Surgical Training through Assessment of Surgical Entrustable Professional Activities

Area of Science:

• Surgical Education
• Competency-Based Assessment
• Medical Simulation

Background:

• Assessing surgical resident competency is complex and broadly defined by accrediting bodies.
• Existing assessment methods vary, lacking specificity for procedural skills.

Purpose of the Study:

• To evaluate the effectiveness of a bundled assessment approach using the surgical entrustable professional activity (SEPA) framework.
• To determine resident competency in managing breast cancer and gallbladder disease.

Main Methods:

• A pilot study utilized multiple assessment tools: multiple choice exam (MCE) from SCORE, CAMEO form, Virtual Surgical Patient (VSP), and Operative Performance Rating System (OPRS).
• Ten surgical residents participated, with five assessed for breast SEPA and five for gallbladder SEPA.

Main Results:

• For breast SEPA, scores did not correlate with postgraduate year (PGY) level; MCE and VSP showed weakest performance.
• Gallbladder SEPA effectively differentiated junior and senior residents, with all junior residents needing remediation on OPRS, while seniors passed.
• Senior residents received "excellent" ratings for operative flow, while juniors received "good".

Conclusions:

• The SEPA framework offers a structured method to define and capture specific areas of surgical competence.
• Bundled assessments within the SEPA format may provide a valid tool for evaluating resident abilities across different disease processes.