Entrustable Professional Activities in endocrine surgery: A national pilot study.

Area of Science:

• Medical Education
• Surgical Training
• Endocrine Surgery

Background:

• The American Association of Endocrine Surgeons developed Entrustable Professional Activities (EPAs) to standardize trainee assessment.
• EPAs define core competencies essential for comprehensive endocrine surgery.

Purpose of the Study:

• To evaluate the implementation and effectiveness of EPAs in assessing endocrine surgery trainees.
• To analyze trainee performance and entrustment levels across different surgical phases and subspecialties.

Main Methods:

• A multi-institutional study involving 10 institutions collected 698 microassessments of trainee performance on 14 defined EPAs.
• Assessments utilized a 5-point entrustment scale via a web-based platform from July 2022 to September 2023.

Main Results:

• Trainee entrustment scores significantly improved in the latter half of the academic year (38.2% to 80.1% highest scores).
• Intraoperative entrustment was lowest for adrenal surgery (11.1%) compared to thyroid (37.0%) and parathyroid (39.4%).
• Trainees achieved higher entrustment in preoperative (28.5%) and postoperative (53.5%) phases compared to intraoperative phases (23.6%).

Conclusions:

• Entrustment scores demonstrate a learning curve, with significant improvement observed during the academic year.
• Nonoperative phases of care (preoperative and postoperative) allow for earlier trainee entrustment compared to intraoperative skills.