Implementing Entrustable Professional Activities in Pediatric Fellowships: Facilitating the Process.

Area of Science:

• Medical Education
• Pediatric Subspecialties
• Professional Assessment

Background:

• The American Board of Pediatrics mandates Entrustable Professional Activities (EPAs) for initial certification by 2028.
• Currently, less than half of pediatric fellowships utilize EPAs for assessment, necessitating widespread adoption.
• Fellowship Program Directors' (FPDs) perceptions and experiences with EPAs and Milestones are crucial for successful implementation.

Purpose of the Study:

• To identify facilitators and barriers in implementing EPAs for pediatric fellow assessment.
• To understand FPDs' perceptions of EPAs compared to Milestones.
• To guide future EPA adoption strategies in pediatric subspecialties.

Main Methods:

• A survey was distributed to FPDs across 15 pediatric subspecialties.
• EPA users reported on implementation, barriers, and perceptions.
• Non-users detailed deterrents, while both groups discussed facilitators and Milestone perceptions.

Main Results:

• A 65% response rate (575/883) was achieved, with 59.8% EPA users and 40.2% non-users.
• Work burden was a common barrier; non-users reported significantly more barriers than users.
• Users found EPAs clearer and more reflective of practice than Milestones; non-users had mixed perceptions.

Conclusions:

• Successful EPA implementation requires significant FPD investment, supported by clear guidance and accessible resources.
• Key barriers include FPD time constraints, the need for assessment tools, and outcome data.
• Collaborative efforts from multiple organizations are essential to overcome implementation challenges.