Assessment Tools for Feedback and Entrustment Decisions in the Clinical Workplace: A Systematic Review

Area of Science:

• Medical Education
• Workplace-Based Assessment
• Healthcare Professional Development

Background:

• Entrustable Professional Activities (EPAs) integrate feedback, evaluation, and permission for supervised practice.
• EPAs facilitate scheduling learners for clinical service, bridging education and patient care.
• Identifying effective assessment tools is crucial for guiding learner autonomy.

Purpose of the Study:

• To identify workplace-based assessment tools supporting progression toward unsupervised practice.
• To evaluate tools suitable for entrustment decisions and learner feedback.
• To inform the development and application of EPAs in medical training.

Main Methods:

• Systematic literature search across PubMed, Embase, ERIC, and PsycINFO databases.
• Inclusion/exclusion criteria applied to titles, abstracts, and full texts.
• Data extraction on assessment tools and methodological quality assessment (MERSQI).

Main Results:

• 6,371 articles screened, 80 included, identifying 67 distinct assessment tools.
• Few studies explicitly linked assessment tools to entrustment decisions.
• High average methodological quality (MERSQI score of 10.0) and frequent reporting of validity evidence.

Conclusions:

• Numerous workplace-based assessment tools exist that can provide developmental feedback to learners.
• Existing tools and principles can be adapted for entrustment decisions, supervision levels, and autonomy.
• Further research is needed to explicitly connect assessment tools with entrustment decision-making frameworks.