Comparing Entrustment Decision-Making Outcomes of the Core Entrustable Professional Activities Pilot, 2019-2020.

Area of Science:

• Medical Education
• Graduate Medical Education
• Patient Safety

Background:

• Gaps in resident readiness for indirect supervision pose patient safety risks.
• Core Entrustable Professional Activities (EPAs) for entering residency aim to strengthen the transition from medical school to residency.

Purpose of the Study:

• To assess progress in developing an entrustment process within the Core EPAs framework.
• To evaluate the effectiveness of interventions aimed at improving resident readiness for indirect supervision.

Main Methods:

• A quality improvement study involving four medical schools from 2019-2020.
• Trained faculty made theoretical entrustment determinations using workplace-based assessments (WBAs).
• Data on EPA-specific readiness, WBA volume, and entrustment decisions were collected and analyzed.

Main Results:

• The proportion of residents deemed ready for indirect supervision increased significantly from 43.4% to 60.1%.
• The availability of 4 or more WBAs per determination also increased substantially, from 19.9% to 42.1%.
• Despite overall progress, specific Core EPAs (e.g., patient safety, informed consent) showed persistent deficiencies in readiness and WBA availability.

Conclusions:

• The Core EPAs framework demonstrates progress in resident entrustment and WBA data collection.
• Improvements were noted in the proportion of residents ready for indirect supervision and the volume of assessments.
• Significant gaps persist for certain Core EPAs, necessitating targeted interventions to ensure comprehensive resident preparedness.