Validity Evidence for Assessing Entrustable Professional Activities During Undergraduate Medical Education

Area of Science:

• Medical Education
• Competency-Based Assessment
• Healthcare Professional Development

Background:

• Entrustable Professional Activities (EPAs) are increasingly used as assessment frameworks in medical education.
• Validating these frameworks is crucial for ensuring reliable evaluation of student competence.

Purpose of the Study:

• To explore validity evidence for using Entrustable Professional Activities (EPAs) as an assessment framework in medical education.
• To analyze the developmental progression of student competence based on EPA assessments.

Main Methods:

• Collected formative assessments on six Core EPAs for four cohorts of medical students over a 9-12 month period.
• Utilized direct observation and a 9-point rating scale for supervisor assessments.
• Applied regression models to analyze student performance curves over time, with observations as the unit of analysis.

Main Results:

• Frequent EPA assessments revealed a developmental picture of competence aligning with learning curve theory.
• This developmental progression was consistent across various EPAs and students.
• The time required to reach the performance threshold for entrustment varied by individual student and specific EPA.

Conclusions:

• The study provides validity evidence supporting EPA-based assessment programs.
• Multiple observations of Core EPAs demonstrate a classic developmental progression toward competence and entrustment.
• Future research with larger datasets will enable further psychometric analysis of EPA assessment.