The influence of clinical coaching teams on quality of entrustable professional activity assessments

Coaching is an important component of workplace-based assessment in competency-based medical education. Longitudinal coaching relationships have been proposed to enhance the trainee-supervisor relationship and promote high-quality assessment.

The objective of this study was to determine the influence of longitudinal coaching relationships on the quality of entrustable professional activity (EPA) assessments.

EPAs (n = 174) completed by emergency medicine (EM) supervisors between July 2020 and June 2021 were extracted and divided into two groups; one group consisted of EPAs completed by supervisors when a longitudinal coaching relationship existed (n = 87) and the other group consisted of EPAs completed by the same supervisors when no coaching relationship existed (n = 87). Three physicians were recruited to rate the EPAs using the Quality of Assessment and Learning (QuAL) score, a previously published measure of EPA quality. An analysis of variance was performed to compare mean QuAL scores between the groups. Linear regression analysis was conducted to examine the relationship between trainee performance (EPA rating) and EPA assessment quality (QuAL score).

All raters completed the survey. The mean ± SD QuAL score in the coaching relationship group (3.63 ± 0.91) was higher than the no coaching relationship group (3.51 ± 1.10) but the difference was not statistically significant (p = 0.40). Supervisor was a significant predictor of QuAL score (p = 0.012) and supervisor alone accounted for 26% of the variability in QuAL scores (R² = 0.26). There was no significant relationship between trainee performance and EPA assessment quality.

The presence of a longitudinal coaching relationship did not influence the quality of EPA assessments.