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Related Experiment Video

Updated: Jun 26, 2025

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Decision-Making Confidence of Clinical Competency Committees for Entrustable Professional Activities.

Kelsey B Montgomery1, John D Mellinger2,3, M Chandler McLeod1

  • 1Department of Surgery, University of Alabama at Birmingham.

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|May 8, 2024
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Summary
This summary is machine-generated.

Clinical Competency Committees (CCCs) reported higher confidence in entrustment decisions as the number of EPA microassessments increased. This supports the validity of the new competency-based assessment framework for surgical residents.

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Area of Science:

  • Medical Education
  • Surgical Training
  • Competency-Based Assessment

Background:

  • The American Board of Surgery endorsed a competency-based assessment framework using Entrustable Professional Activities (EPAs).
  • A 2-year feasibility pilot study involved Clinical Competency Committees (CCCs) rating surgical residents on EPA entrustment.
  • Factors influencing CCC decision-making confidence in these entrustment decisions remain unknown.

Purpose of the Study:

  • To identify factors associated with variations in CCC decision-making confidence.
  • To assess confidence levels in summative entrustment decisions for EPAs in general surgery residency programs.

Main Methods:

  • A cohort study analyzed deidentified data from the EPA Pilot Study (2018-2020) across 28 general surgery residency programs.
  • Data included semiannual EPA microassessments and CCC summative entrustment ratings.
  • Bivariate tests and mixed-effects regression modeling evaluated factors associated with CCC confidence.

Main Results:

  • Of 1765 summative entrustment decisions, 72.5% were made with moderate or high CCC confidence.
  • Confidence ratings significantly increased with a higher number of EPA microassessments received.
  • Each additional microassessment was associated with increased odds of higher CCC confidence, with variations across different EPA phases.

Conclusions:

  • CCC confidence in summative EPA entrustment decisions correlates positively with the number of available microassessments.
  • The findings provide initial validity evidence for the EPA framework in surgical education.
  • This study may guide the implementation of EPAs in residency programs nationwide.