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Home Field Advantage? Comparing the Quality of EPA Observations Completed On- vs Off-Service
Kaitlin Endres1, Timothy J Wood2, Nancy Dudek3
1is a Senior Emergency Medicine Resident, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Journal of Graduate Medical Education
|August 20, 2025
Summary
Workplace-based assessments (WBAs) for emergency medicine (EM) residents are lower quality when completed by non-EM assessors compared to EM assessors. This impacts the reliability of performance data for resident evaluation.
Area of Science:
- Medical Education
- Emergency Medicine
- Assessment Quality
Background:
- Supervisors may assess residents differently based on disciplinary alignment.
- Robust performance data is crucial for high-stakes decisions in resident training.
- Understanding assessment quality is vital for reliable evaluation.
Purpose of the Study:
- To compare the quality of workplace-based assessments (WBAs) for emergency medicine (EM) residents.
- To evaluate WBAs provided by EM versus non-EM assessors.
Main Methods:
- Retrospective database study analyzing WBAs using the Quality of Assessment of Learning (QuAL) score.
- Included 5 entrustable professional activities (EPAs) across EM and non-EM rotations.
- 250 WBAs were rated by blinded EM physician raters.
Main Results:
- WBAs completed during EM rotations had significantly higher QuAL scores than those from non-EM rotations (3.66 vs 3.02).
- Procedural EPAs received higher quality scores than non-procedural EPAs (3.61 vs 3.16).
Conclusions:
- The quality of WBAs for EM residents is lower when completed during non-EM rotations.
- Assessment quality differs based on the assessor's discipline.
- Findings highlight potential disparities in performance data collection.
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