Entrustment Decision Making in the Core Entrustable Professional Activities: Results of a Multi-Institutional Study.

Area of Science:

• Medical Education
• Competency-Based Education

Background:

• The Association of American Medical Colleges developed 13 Core Entrustable Professional Activities (EPAs) for graduating medical students.
• A pilot program involving 10 schools tested the implementation of the Core EPAs framework.

Purpose of the Study:

• To assess the feasibility of making summative entrustment decisions for Core EPAs.
• To determine the extent to which graduating students were deemed ready for indirect supervision.

Main Methods:

• Trained Entrustment Groups (TEGs) reviewed assessment data for 349 students across 4 schools.
• TEGs recorded entrustment decisions, confidence levels, and the number of workplace-based assessments (WBAs).
• Chi-square analysis was used to examine associations between variables.

Main Results:

• Of 2,415 EPA determinations, 41.3% resulted in a 'ready' decision, 23.1% 'progressing but not yet ready,' and 7.2% 'evidence against progression.'
• No decision could be made for 28.4% of determinations, often due to insufficient data.
• Entrustment decisions varied across EPAs, and WBA availability influenced the ability to make decisions.

Conclusions:

• Trained Entrustment Groups could make entrustment decisions, but less than half of students were deemed ready for indirect supervision.
• Additional efforts are required to achieve authentic summative entrustment within the Core EPAs framework.