Fidelity to Best Practices in EPA Implementation: Outcomes Supporting Use of the Core Components Framework From the...

Area of Science:

• Medical Education
• Competency-Based Medical Education
• Assessment Fidelity

Background:

• The expansion of Entrustable Professional Activities (EPAs) necessitates robust implementation strategies.
• Ensuring fidelity and integrity in EPA assessment programs is crucial for competency-based medical education goals.
• This article details the structure and outcomes of the University of Virginia (UVA) EPA Program.

Purpose of the Study:

• To describe the structure and outcomes of the UVA EPA Program.
• To provide support for essential components of EPA implementation.
• To address the need for fidelity in EPA assessment programs.

Main Methods:

• Utilized workplace assessments involving residents/fellows, attending faculty, and master assessors (MAs).
• Implemented formal professional development for all assessors.
• Established an Entrustment Committee of MAs to aggregate data and make summative entrustment decisions.

Main Results:

• Over 2,000 assessors completed 56,969 EPA assessments for 1,479 students since 2017.
• The majority of assessments (94%) occurred during the clerkship phase.
• Assessments involved diverse settings and patient acuity, with 87% including detailed narrative comments.

Conclusions:

• The UVA EPA Program demonstrates a structured approach to competency-based assessment.
• The program's outcomes support the identified essential components for EPA implementation.
• Future plans include enhanced identification of students needing support and targeted assessor development.