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Measures of variability are statistical metrics that reveal the dispersion pattern within a dataset. They are pivotal in biostatistics, providing insights into the heterogeneity within health and biological data. Variability signifies the degree to which data points diverge from one another, helping researchers understand the potential range of values and associated uncertainty within the data.
The range is a simple measure of variability, indicating the difference between the highest and...
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Framing our Expectations: Variability in Entrustable Professional Activity Assessments.

Maggie E Jones-Carr1, Chandler McLeod1, Samantha Baker2

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

Journal of Surgical Education
|August 20, 2024
PubMed
Summary
This summary is machine-generated.

Surgical faculty and trainees could identify high and low-performing residents using the American Board of Surgery (ABS) Entrustment Scale in video scenarios. Frequent observation and video-based training are recommended to improve entrustment decisions.

Keywords:
Entrustable professional activitiesframe-of-referencelearning assessmentsresident evaluations

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Area of Science:

  • Medical Education
  • Surgical Training
  • Assessment Methods

Background:

  • Assessing resident competency in surgical training is crucial for patient safety and effective skill development.
  • The American Board of Surgery (ABS) Entrustment Scale provides a framework for evaluating learner performance.
  • Understanding the reliability of entrustment decisions among different rater groups is essential for accurate assessment.

Purpose of the Study:

  • To evaluate the accuracy of surgical trainees and faculty in interpreting resident entrustment levels.
  • To assess the ability of raters to correctly categorize learner performance in modeled patient care scenarios using video.
  • To identify potential variability in entrustment decisions and inform strategies for improving assessment reliability.

Main Methods:

  • A prospective study was conducted using a web-based survey with four video recordings of resident learners.
  • Respondents (surgical trainees and faculty) rated learner performance against specific levels of the ABS Entrustment Scale.
  • Responses were analyzed for accuracy, with a focus on differentiating between high and low entrustment levels.

Main Results:

  • Overall accuracy in identifying targeted entrustment levels varied, with initial difficulty in a high-entrustment scenario (36% correct).
  • Subsequent scenarios showed improved accuracy (70-84% correct), and both trainees and faculty achieved 95% accuracy when categorizing into broad high/low entrustment.
  • Faculty demonstrated higher accuracy than trainees in identifying low entrustment for intraoperative inguinal hernia repair (95% vs. 60%, p=0.03).

Conclusions:

  • Surgical trainees and faculty can identify high- and low-performing residents via video demonstrations using the ABS Entrustment Scale.
  • Variability in rater perceptions and scenario complexity necessitate frequent observations of Entrustable Professional Activities (EPAs).
  • Video-based frame-of-reference training may enhance the consistency and effectiveness of EPA implementation and assessment.