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Viewing Readiness-for-Residency through Binoculars: Mapping Competency-Based Assessments to the AAMC's 13 Core

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Summary

Graduating medical students' readiness-for-residency can be assessed using established competency-based tools mapped to Entrustable Professional Activities (EPAs). This approach provides meaningful feedback for students and faculty.

Keywords:
EPAsEntrustable professional activitiesassessmentcompetency-based medical educationundergraduate medical education

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Area of Science:

  • Medical Education
  • Health Professions Education
  • Assessment

Background:

  • Readiness-for-residency for graduating medical students is inconsistently assessed.
  • The Association of American Medical Colleges (AAMC) identified 13 core Entrustable Professional Activities (EPAs) for residents.
  • Standardized measurement guidelines for EPAs were lacking, prompting the development of new assessment methods.

Purpose of the Study:

  • To assess and address graduating medical students' readiness-for-residency using a novel simulation.
  • To map existing competency-based assessments to the AAMC's core EPAs.
  • To evaluate the reliability and validity of a blended assessment framework.

Main Methods:

  • A consensus-based mapping process was conducted by health professions educators.
  • 310 competency-based checklist items were mapped to AAMC core EPA entrustable behaviors.
  • A blended suite of 14 checklists was developed and utilized in an immersive simulation (Night-on-Call).

Main Results:

  • The 14 checklists captured all 13 core EPAs to varying degrees (Intraclass Correlation Coefficient [ICC] = 0.77).
  • Consensus meetings improved reliability for EPAs with initially poor ICC values (EPA-9, EPA-10, EPA-12).
  • Established competency-based assessments can be repurposed to measure EPA components.

Conclusions:

  • Repurposing competency-based assessments is a viable method for measuring readiness-for-residency through an EPA lens.
  • The developed assessment framework provides meaningful feedback to transitioning students and faculty.
  • Limitations exist, particularly for specific EPAs like forming clinical questions and retrieving evidence.