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

BACKGROUND: Entrustable Professional Activities (EPAs) combine feedback and evaluation with a permission to act under a specified level of supervision and the possibility to schedule learners for clinical service. This literature review aims to identify workplace-based assessment tools that indicate progression toward unsupervised practice, suitable for entrustment decisions and feedback to learners. METHODS: A systematic search was performed in the PubMed, Embase, ERIC, and PsycINFO databases. Based on title/abstract and full text, articles were selected using predetermined inclusion and exclusion criteria. Information on workplace-based assessment tools was extracted using data coding sheets. The methodological quality of studies was assessed using the medical education research study quality instrument (MERSQI). RESULTS: The search yielded 6,371 articles (180 were evaluated in full text). In total, 80 articles were included, identifying 67 assessment tools. Only a few studies explicitly mentioned assessment tools used as a resource for entrustment decisions. Validity evidence was frequently reported, and the MERSQI score was 10.0 on average. CONCLUSIONS: Many workplace-based assessment tools were identified that potentially support learners with feedback on their development and support supervisors with providing feedback. As expected, only few articles referred to entrustment decisions. Nevertheless, the existing tools or the principals could be used for entrustment decisions, supervision level, or autonomy.