Redesigned Entrustable Professional Activity (EPA) Assessments Reduce Grade Inflation in the Experiential Setting

Area of Science:

• Pharmacy Education
• Medical Education Assessment
• Entrustable Professional Activities (EPAs)

Background:

• Accurate assessment of student performance is crucial in pharmacy education.
• Traditional assessment tools may be susceptible to grade inflation.
• Entrustable Professional Activities (EPAs) are a framework for competency-based assessment.

Purpose of the Study:

• To evaluate the impact of a redesigned EPA assessment tool on the accuracy of student performance assessment.
• To determine if changes in the EPA tool affect grade inflation in pharmacy education.

Main Methods:

• Retrospective analysis of 3-year programmatic data for students on clinical rotations.
• Comparison of preceptor-assigned entrustment levels with suggested levels using chi-squared tests.
• Redesigned tool separated formative EPA feedback from final grade determination.

Main Results:

• A 3% decrease in students scoring above suggested entrustment levels.
• An increase in students scoring at or below suggested entrustment levels (+1% and +2%).
• Observed decrease in grade inflation and increase in accurate assessments in clinical settings.

Conclusions:

• The redesigned EPA assessment tool led to more accurate student performance evaluations.
• Separating formative feedback from final grades and using holistic descriptors improved assessment alignment.
• Pharmacy education may benefit from emphasizing formative feedback and holistic assessment in EPA evaluations.