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Implementing Core Entrustable Professional Activities in Undergraduate Medical Education: A Psychometric Study.

Claudio Violato, Robert Englander, Esther Dale

    Academic Medicine : Journal of the Association of American Medical Colleges
    |November 1, 2024
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    Summary
    This summary is machine-generated.

    Entrustable Professional Activities (EPAs) assessments in medical education are feasible and provide dependable data for evaluating student performance and making entrustment decisions. This study demonstrates their reliability in undergraduate medical training.

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    Area of Science:

    • Medical Education
    • Assessment in Health Professions Education
    • Competency-Based Medical Education

    Background:

    • Entrustable Professional Activities (EPAs) are increasingly used in medical education to assess clinical competence.
    • Evaluating the psychometric properties and feasibility of EPA-based assessments is crucial for their effective implementation.
    • Understanding learning curves and time to entrustment provides insights into student development.

    Purpose of the Study:

    • To assess the feasibility and psychometric properties of EPA assessments in undergraduate medical education.
    • To analyze learning curves, time to entrustment, and data dependability using generalizability theory (G theory).
    • To determine the reliability of EPA data for making entrustment decisions.

    Main Methods:

    • Third-year medical students (n=240) at the University of Minnesota underwent EPA assessments across 7 clerkships.
    • Students received an average of 4 EPA assessments weekly from faculty, residents, or experts.
    • Performance data were analyzed using regression models for learning curves and G theory for dependability.

    Main Results:

    • A total of 32,614 EPA assessments were collected, with an overall score dependability of 0.75 achieved with 4 assessors and 4 occasions.
    • 100% of students met entrustment levels for EPAs 1, 6, and 7 by academic year-end.
    • Significant learning growth was observed, particularly for EPA 2 (β 0 = .286).

    Conclusions:

    • EPA ratings are reliable and dependable for assessing student performance in clinical settings.
    • EPA-based assessment systems can effectively support entrustment decisions in medical education.
    • The findings support the integration of EPAs as a core component of clinical assessment programs.