Using the EPAs to Evaluate the Clinical Experience of Medical Students

Although there are standardized assessments of medical students throughout medical school, the clinical experience of each student may vary widely. Currently, medical schools do not have a systematic method to ensure that students perform clinical skills during clinical clerkships. Our study used the Entrustable Professional Activities for Entering Residency (EPAs) framework to assess the ways in which medical students meaningfully participate in patient care at various clinical sites in each required clerkship and over time.

Over the 2020-2021 academic year, 170 third-year medical students were asked to report the number of times they performed EPA-1 (gather history and perform physical examination), EPA-5 (document clinical encounter), and EPA-6 (provide oral presentation of clinical encounter) at the end of each required clinical rotation (emergency medicine, internal medicine, surgery, obstetrics/gynecology, pediatrics, neurology, psychiatry) at a single medical school. We used descriptive statistics and t tests to compare frequency of these EPAs by campus type, site type, clerkship, and time.

One thousand, two hundred sixty-one surveys met inclusion criteria. Students performed EPA-5 more often at an academic medical center, and EPA-1 more frequently in the outpatient setting. Students performed EPA-1 and EPA-6 most often during emergency medicine and EPA-5 most often during internal medicine. Performance of all three EPAs increased over time.

This reporting system produced a robust data set that allowed for EPA performance comparisons by campus, site type, clerkship, and time. EPA performance varied by rotation, site type, clerkship, and time.