Identifying Core Components of EPA Implementation: A Path to Knowing if a Complex Intervention Is Being Implemented...

Area of Science:

• Medical Education
• Assessment Science

Background:

• Competency-based assessment using entrustable professional activities (EPAs) is rapidly expanding globally.
• Lack of consensus on essential EPA assessment elements hinders effective implementation.
• A shared mental model is crucial for accurately implementing EPA frameworks.

Purpose of the Study:

• To identify the essential core components for maintaining the integrity of EPA-based assessment implementation.
• To establish a foundation for consistent and effective application of EPA frameworks worldwide.

Main Methods:

• A Delphi process involving 12 EPA experts from three countries was employed.
• Experts rated candidate core components using a 1-6 scale over three rounds.
• Predetermined inclusion (≥80% rating 5-6) and exclusion (≥80% rating 1-2) criteria were used.

Main Results:

• Ten core components were prioritized for inclusion after three rounds.
• Key components include performance prediction, shared mental models, workplace assessment, and high-stakes entrustment decisions.
• Other prioritized components were outcomes-based assessment, collective value, informed committee members, construct alignment, qualitative data, and decision consequences.

Conclusions:

• The identified core components are vital for implementing EPA assessment frameworks as intended.
• Utilizing these components helps ensure accurate interpretation of intervention outcomes.
• This research provides a framework for robust and reliable EPA-based assessment.