Motivations for Entrustable Professional Activity Assessment: Gaps Between Curriculum Theory and Resident Reality.

Area of Science:

• Medical Education
• Competency-Based Medical Education (CBME)

Background:

• Mixed resident reactions to competency-based medical education (CBME) and entrustable professional activities (EPAs) are documented.
• Understanding resident motivation for EPAs is crucial for CBME sustainability, emphasizing assessment for learning.

Purpose of the Study:

• Explore resident perspectives on motivation for obtaining EPAs.
• Assess the perceived importance of EPAs for learning.
• Gather overall resident feedback on the CBME curriculum.

Main Methods:

• Sequential exploratory mixed-methods study involving interviews and surveys.
• Semi-structured interviews (n=25) and electronic surveys (n=107) with Canadian residents in CBME.
• Thematic, manifest content, and descriptive analyses were employed.

Main Results:

• Program requirement was the primary driver for residents seeking EPAs.
• Perceived importance of EPAs for learning varied among residents.
• Critiques included increased workload, 'gaming the system,' and lack of preceptor ownership.

Conclusions:

• Many residents acknowledge EPA value, but intrinsic motivation for assessment is lacking in the current CBME framework.
• Current CBME structures may not fully align with residents' learning goals, impacting engagement with EPAs.