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Does PGY Level Equate Entrustment Level? Variability in Faculty Entrustment Ratings.

Julia Adriana Kasmirski1, Martin Paul Jones1, Niranjna Swaminathan1

  • 1Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alberta.

Journal of Surgical Education
|September 2, 2025
PubMed
Summary
This summary is machine-generated.

Faculty show variability in rating surgical residents' Entrustable Professional Activities (EPAs). Senior residents (PGY3-5) had higher entrustment scores and greater score variability than junior residents (PGY1-2).

Keywords:
assessmentcompetency-based assessmentcompetency-based educationentrustable professional activities

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Area of Science:

  • Medical Education
  • Surgical Training
  • Competency-Based Education

Background:

  • The Entrustable Professional Activities (EPAs) framework is crucial for assessing resident competency in medical education.
  • Limited data exists on faculty variability in assigning entrustment levels within the EPA framework, particularly in general surgery.

Purpose of the Study:

  • To assess faculty variability in entrustment level ratings for general surgery residents across different postgraduate years (PGY).
  • To compare entrustment score variability between junior (PGY1-2) and senior (PGY3-5) residents.

Main Methods:

  • Collected 1108 intra-operative EPA assessments from 52 faculty raters over one year.
  • Calculated EPA score variance for individual raters within PGY levels, excluding those with fewer than 5 assessments.
  • Used Levene's test and Bonferroni correction for variability comparison and linear mixed models for mean score comparison.

Main Results:

  • Mean entrustment scores significantly increased with PGY (1.72 for PGY1 to 3.33 for PGY5).
  • Junior residents (PGY1-2) achieved lower entrustment levels (1-3) with no significant difference in variability between them.
  • Senior residents (PGY3-5) showed a wider range of entrustment (2-4) with significantly higher overall entrustment and score variability compared to juniors.

Conclusions:

  • Faculty exhibit considerable variability in assigning EPA scores to residents within the same PGY level.
  • Increased variability in EPA ratings for senior residents suggests differential development of operative skills.
  • Findings highlight the need for standardized faculty assessment and feedback within competency-based surgical training programs.