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Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training.

Glenn E Woodworth¹, Adrian P Marty², Pedro P Tanaka³

¹From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.

Anesthesia and Analgesia

|March 4, 2021

Summary

This study developed 20 anesthesiology entrustable professional activities (EPAs) and 159 procedural skills assessments. A pilot test in 7 residency programs showed the system

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Area of Science:

Medical Education
Competency Assessment
Anesthesiology Training

Background:

Modern medical education necessitates robust competency assessment.
The Accreditation Council for Graduate Medical Education (ACGME) offers competency frameworks but lacks standardized assessment tools.
Entrustable Professional Activities (EPAs) offer a workplace-based solution for assessing competency milestones in clinical settings.

Purpose of the Study:

To develop and pilot a standardized system for assessing anesthesiology resident competency using EPAs.
To map EPAs to ACGME milestones and establish entrustment targets for graduating residents.
To evaluate the usability and utility of a mobile application for EPA and procedural skills assessment.

Main Methods:

A modified Delphi method with 18 education experts was used to achieve consensus on EPAs, an entrustment scale, and procedural skills.
A list of 20 EPAs and 159 procedural skills was developed, mapped to ACGME milestones.
A website and mobile app were created for assessment, piloted at 7 anesthesiology residency programs.

Main Results:

Consensus was reached on 20 EPAs and 159 procedural skills, with defined entrustment scales and graduation targets.
Faculty surveys indicated favorable usability and utility of the assessment app.
During the pilot, 1636 EPA and 1427 procedure assessments were submitted in 2 months, with continued use throughout the year.

Conclusions:

A rigorous methodology yielded 20 anesthesiology EPAs and 159 procedural skills assessments.
Pilot testing demonstrated the feasibility of implementing a mobile app-based assessment system.
Variable adoption rates were observed, highlighting the need for further integration strategies.