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(En)trust me: Validating an assessment rubric for documenting clinical encounters during a surgery clerkship clinical
Tess H Aulet1, Jesse S Moore2, Peter W Callas3
1Department of Surgery, University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT, 05401, USA.
Background:
The AAMC developed 13 Core Entrustable Professional Activities (EPAs) for graduating medical students. EPA 5 is: Document a clinical encounter in the patient record. Our goal was to develop an assessment rubric and gather evidence to support its validity in measuring progress towards entrustability.
Methods:
A rubric was developed for EPA 5. During the 2017 surgery clerkship, 57 students wrote a note for each of two standardized patient (SP) encounters. These notes were prospectively collected and assessed by two physician raters. Messick's validity framework was used to gather validity data.
Results:
Inter-rater reliability with two raters was excellent, ICC = 0.86 (ICC 95%, confidence interval (CI) 0.80-0.90) for overall note score. Correlation between note items and SP checklists ranged 0.39-0.46 (p < 0.05) and between note items and clinical evaluations 0.28-0.39 (p < 0.05).
Conclusions:
There is initial reliability evidence supporting the use of our rubric for assessing progress towards entrustability of EPA 5.
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