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Validity Evidence for Level of Supervision Scales With Pediatric Subspecialty-Specific Entrustable Professional
Angela S Czaja1, Alan Schwartz2, Scott H James3
1Department of Pediatrics (AS Czaja), Critical Care, University of Colorado School of Medicine, Aurora, Colo.
Academic Pediatrics
|July 23, 2025
Summary
Supervision scales for pediatric subspecialty Entrustable Professional Activities (EPAs) demonstrate strong validity evidence. These scales are easy to use and show growth in supervision levels, supporting fellow assessment.
Area of Science:
- Medical Education Research
- Assessment in Pediatrics
- Competency-Based Medical Education
Background:
- Assessing fellows in pediatric subspecialties requires robust tools.
- Entrustable Professional Activities (EPAs) are key milestones in training.
- Validity evidence is crucial for assessment scale reliability.
Purpose of the Study:
- To generate validity evidence for supervision scales used in assessing pediatric subspecialty EPAs.
- To evaluate the usability and psychometric properties of these assessment tools.
- To align supervision ratings with fellow competency development.
Main Methods:
- Collected supervision ratings for 3,312 fellows across 14 pediatric subspecialties (2018-2022).
- Assessed internal consistency (Cronbach's alpha) and inter-EPA consistency.
- Used mixed effects models to analyze growth in supervision levels and correlations with milestone ratings.
Main Results:
- High internal consistency (alpha 0.89-0.97) and inter-EPA consistency were observed.
- Program directors found the scales easy to use with minimal time commitment.
- Consistent growth in supervision levels across fellowship years and a positive correlation with milestone competencies were found.
Conclusions:
- The study provides strong validity evidence for using subspecialty-specific EPA supervision scales to assess pediatric fellows.
- These scales are practical and demonstrate psychometric soundness.
- Further evaluation is recommended for their role in individualized learning and high-stakes decisions.
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