Simulation as a Platform for Development of Entrustable Professional Activities: A Modular, Longitudinal Approach.

Area of Science:

• Medical Education
• Simulation-Based Learning
• Competency-Based Education

Background:

• The Association of American Medical Colleges (AAMC) identified core Entrustable Professional Activities (EPAs) for medical graduates.
• Challenges exist in direct observation and deliberate practice of EPA behaviors in clinical settings.
• Limited literature describes comprehensive, longitudinal curricula for formative EPA assessment.

Purpose of the Study:

• To present a model curriculum for longitudinal, formative assessment of EPA skills throughout medical school clinical years.
• To describe a curriculum framework utilizing simulation and small group activities for EPA development.
• To provide a scalable model for assessing core EPAs in medical students.

Main Methods:

• A longitudinal, modular curriculum framework was developed.
• Each EPA-focused session included a simulation case followed by small group activities.
• Implementation involved third-year (MS3) and fourth-year (MS4) medical students across multiple schools.

Main Results:

• Over 450 MS3 students, 30 MS4 sub-internship students, and 300+ MS4 capstone students participated.
• Sessions covered EPAs 4, 7, 8, 9, 10 (MS3) and EPA 8 (MS4), with the capstone covering nearly all 13 EPAs.
• Student feedback was overwhelmingly positive, indicating simulations are effective for formative EPA assessment.

Conclusions:

• Simulation-based learning is an effective method for formative EPA assessment.
• The curriculum model is implementable across diverse medical student populations.
• Longitudinal formative assessment and deliberate practice are crucial for developing core EPAs prior to final entrustment.