Implementation of entrustable professional activities into fellowship council accredited programs: a pilot project

Area of Science:

• Medical Education
• Surgical Training
• Competency-Based Assessment

Background:

• The Fellowship Council (FC) is transitioning to a competency-based medical education (CBME) model.
• This transition involves implementing Entrustable Professional Activities (EPAs) for training and assessment.

Purpose of the Study:

• To describe the implementation process of EPAs during a ten-month pilot project.
• To present data on the feasibility and perceived value of EPAs.

Main Methods:

• EPAs were developed collaboratively with sponsoring societies for various surgical fellowships.
• Fifteen accredited fellowship programs participated, collecting assessments via a dedicated online platform.
• Clinical Competency Committees (CCCs) convened quarterly, with pilot groups meeting monthly to refine the process.

Main Results:

• A total of 655 assessments were initiated, with 429 (65%) completed across 18 fellows and 106 faculty.
• Fellows completed an average of 24 EPAs, with intraoperative EPAs being most frequent (71%).
• Engagement increased over time, and the entrustment level rose from 6% to 75% 'Practice Ready'.

Conclusions:

• A competency-based assessment framework using EPAs was successfully developed and piloted.
• Variable participation highlighted the need for ongoing strategies to address implementation barriers.
• The pilot project has prepared the FC for broader CBME implementation across all training programs.