E-ASSESS: Creating an EPA Assessment Tool for Structured Simulated Emergency Scenarios

Area of Science:

• Medical Education
• Simulation-Based Assessment
• Physician Training

Background:

• The Entrustable Professional Activity (EPA) framework guides supervisor entrustment decisions for physician trainees.
• Limited direct observation, particularly for infrequent activities, challenges EPA assessment.
• Simulation offers opportunities for direct observation and could enhance trainee assessments.

Purpose of the Study:

• To develop and validate a simulation-based assessment tool aligned with the EPA framework.
• To explore the utility of simulation for EPA assessment in pediatric residency.

Main Methods:

• Developed E-ASSESS (EPA Assessment for Structured Simulated Emergency ScenarioS) for 2 EPAs in pediatric residents.
• Collected validity evidence using Messick's framework.
• Compared entrustment ratings from simulation (E-ASSESS) with clinical supervisor ratings.

Main Results:

• Intraclass correlation (ICC) for E-ASSESS ratings ranged from 0.65-0.77, exceeding ICC for the clinical tool (0.59-0.57).
• No significant correlations were found between E-ASSESS and clinical practice ratings for either EPA.
• Twenty-eight residents participated in the simulation-based team training.

Conclusions:

• Simulation-based EPA assessment provides valuable data for entrustment decisions.
• This approach can complement traditional clinical assessments in resident evaluation.
• Further research may refine simulation tools for comprehensive EPA assessment.