EHR-Driven Delivery of EPA Assessments Significantly Improves Participation

Area of Science:

• Medical Education
• Digital Health
• Surgical Training

Background:

• Digital education tools are crucial for Competency-Based Medical Education (CBME) via EPAs.
• Understanding EHR integration, device access, and user behavior is vital for successful implementation.

Purpose of the Study:

• To evaluate the impact of EHR-driven delivery versus manual initiation of EPAs.
• To assess the influence of flexible device access on EPA completion and user engagement.

Main Methods:

• A HIPAA-compliant platform collected EPAs across 21 general surgery programs (July 2023-April 2024).
• Compared 5 EHR-integrated (EHR+) institutions with automated EPA delivery to 16 non-integrated (EHR-) institutions with manual initiation.
• Bundled care phases into cEPAs and analyzed completion rates and user behavior metrics.

Main Results:

• 4187 cEPAs were collected; 82% from EHR+ institutions.
• Automated triggering significantly increased EPA completion (88% faculty, 81% residents).
• Faculty preferred automated OR-triggered EPAs; residents reviewed feedback within 1.5 hours. Computers yielded more comments.

Conclusions:

• EHR-driven EPA delivery increases completion rates 4.6-fold, with automated alerts driving initiation and habit formation.
• Flexible device access enhances EPA completion and feedback utility.
• EHR integration is critical for efficient EPA workflow in surgical education.