How Internal Medicine Clerkship Directors Are Using Entrustable Professional Activities: A National Survey Study

Area of Science:

• Medical Education
• Assessment in Medical Training
• Internal Medicine Clerkships

Background:

• Prevalence and implementation of Entrustable Professional Activities (EPAs) in U.S. internal medicine (IM) clerkships are not well understood.
• EPAs are a framework for assessing learner performance in clinical settings.
• Understanding current EPA adoption is crucial for curriculum development.

Purpose of the Study:

• To determine the prevalence of EPA use in U.S. IM clerkships.
• To describe how EPAs are implemented for learner assessment.
• To identify common frameworks and assessment strategies associated with EPA use.

Main Methods:

• Cross-sectional survey of 140 IM clerkship directors at U.S. medical schools.
• Data collected on EPA adoption, grading, assessment support, and validity.
• Analysis of response rate and statistical significance for key findings.

Main Results:

• 47% of IM clerkships reported using EPAs, with higher adoption in schools accredited after 1977.
• The Association of American Medical Colleges Core EPAs for Entering Residency (CEPAER) was the most common framework (55%).
• EPAs were used for both formative and summative assessments by 56% of users, and for grading by 48%.

Conclusions:

• EPAs are substantially adopted in IM clerkships and used for assessment.
• EPA implementation does not appear to be linked to increased efforts in ensuring assessment validity.
• Further research is needed to enhance the validity of EPA-based assessments.