Agreement of Program Directors With Clinical Competency Committees for Fellow Entrustment

Area of Science:

• Medical Education
• Competency-Based Assessment

Background:

• Fellowship Program Directors (FPDs) and Clinical Competency Committees (CCCs) evaluate fellow performance.
• Entrustable Professional Activities (EPAs) are used to assess competency in medical training.

Purpose of the Study:

• To examine the association between entrustment levels assigned by FPDs and CCCs for pediatric subspecialty EPAs.
• To hypothesize strong correlation and minimal bias between FPD and CCC assessments.

Main Methods:

• FPDs and CCCs separately assigned supervision levels for 6 pediatric subspecialty EPAs.
• Correlation and bias between FPD and CCC assessments were calculated.
• Effects of program size, FPD understanding, and subspecialty were examined.

Main Results:

• Strong correlations were found between FPD and CCC supervision levels for all EPAs (P < .001).
• Correlations were slightly lower when FPDs were not CCC members.
• Overall bias between the two assessment groups was small.

Conclusions:

• A strong correlation exists between FPD and CCC entrustment level assignments.
• Minimal bias suggests FPD and CCC ratings are comparable for determining fellow entrustment.
• The concordance supports the validity of EPAs in competency-based assessment.