Entrustable professional activities for workplace assessment of general practice trainees

Area of Science:

• Medical Education
• General Practice Training
• Workplace-based Assessment

Background:

• Assessing trainee competency is crucial in medical education.
• Entrustable Professional Activities (EPAs) are used to evaluate readiness for unsupervised practice.
• Understanding trainee progression and assessment accuracy is key.

Purpose of the Study:

• To evaluate if entrustment levels for junior trainees increase over time.
• To compare entrustment levels between junior and senior general practice trainees.
• To assess the concordance between trainee and supervisor assessments of entrustment.

Main Methods:

• An observational study was conducted with 130 junior and 153 senior general practice trainees.
• Data were collected in South Australia in 2017.
• Key outcomes measured were differences in entrustment, changes over 9 months, and assessment concordance.

Main Results:

• Senior trainees were 2.1 to 3.7 times more likely to be entrusted with unsupervised clinical EPAs than junior trainees.
• Junior trainees’ unsupervised EPA entrustment increased from 26% to 69% over 12 months.
• Supervisor-trainee assessment differences were smaller for senior trainees (2.93 points) than junior trainees (5.5 points) at 3 months.

Conclusions:

• Entrustable Professional Activities (EPAs) serve as effective tools for workplace-based training assessment.
• Trainee entrustment levels progress with experience.
• Supervisor and trainee self-assessments show better agreement as trainees advance.