Longitudinal Assessment of Resident Performance Using Entrustable Professional Activities

Area of Science:

• Medical Education
• Pediatric Residency Training
• Competency-Based Assessment

Background:

• Entrustable Professional Activities (EPAs) are a novel assessment method in medical education.
• Empirical evidence supporting EPA effectiveness, particularly in pediatrics, is still developing.
• Assessing clinical skills development over time is crucial for resident training.

Purpose of the Study:

• To evaluate the longitudinal progression of pediatric residents' clinical skills using EPA-based assessments.
• To determine the readiness of graduating pediatric residents for unsupervised practice across various EPAs.
• To identify potential discrepancies between resident performance and established practice standards.

Main Methods:

• A prospective cohort study involving pediatric residents across 3 academic years.
• Assessment of 17 general pediatrics EPAs using summative decisions on supervision levels.
• Inclusion of residents from 23 pediatric residency programs within a national network.

Main Results:

• Over 25,000 supervision reports were analyzed for 1987 residents.
• Graduation supervision levels varied significantly by EPA, with some requiring more support.
• Only 8 of 17 EPAs met a performance standard where 90% of trainees achieved unsupervised practice readiness.

Conclusions:

• The study provides initial empirical data on practice readiness derived from EPA assessments.
• Findings suggest potential curricular gaps impacting resident preparedness for independent practice.
• Further research is needed to validate these findings with post-graduation outcomes.