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Usability of ENTRUST as an Assessment Tool for Entrustable Professional Activities (EPAs): A Mixed Methods Analysis
Melissa C Lee1, Edward F Melcer2, Sylvia Bereknyei Merrell3
1Stanford University School of Medicine, Stanford, California.
Journal of Surgical Education
|October 11, 2023
Summary
The ENTRUST virtual patient simulation platform demonstrates high usability for assessing surgical trainees. Its ease of use and engagement are independent of performance, supporting its potential for evaluating entrustable professional activities (EPAs).
Area of Science:
- Medical Education Technology
- Surgical Training Assessment
- Virtual Patient Simulation
Background:
- The American Board of Surgery is shifting to a competency-based education model using entrustable professional activities (EPAs).
- Objective tools are needed to assess surgical trainees' readiness for entrustment within this new model.
- Virtual patient simulation offers a potential avenue for evaluating decision-making skills across surgical phases.
Purpose of the Study:
- To evaluate the usability of the ENTRUST virtual patient simulation platform.
- To assess surgical trainees' decision-making skills in preoperative, intra-operative, and post-operative settings using ENTRUST.
- To determine the platform's suitability for assessing entrustable professional activities (EPAs) in surgical residency.
Main Methods:
- A mixed-methods analysis was conducted with 47 surgical residents (PGY 1-5) at an academic institution.
- Quantitative data included System Usability Scale (SUS) scores and Likert responses, analyzed using descriptive statistics, bivariate, and multivariable regression.
- Qualitative data from open-ended responses were analyzed using the Nielsen-Shneiderman Heuristics framework.
Main Results:
- The ENTRUST platform achieved a median SUS score of 82.5, indicating high usability.
- Usability was independent of ENTRUST performance and showed no significant differences across demographic subgroups.
- Participants found the clinical workup engaging (91.5%) and realistic (85.1%), with themes of educational value, enjoyment, and ease-of-use emerging.
Conclusions:
- The ENTRUST platform demonstrates high usability and acceptability among surgical residents.
- Usability is not correlated with assessment performance, suggesting broad applicability.
- ENTRUST shows potential as a valuable tool for assessing EPAs in surgical residency programs, with ongoing development informed by user feedback.
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