Learner and Teacher Entrustability Concordance in Endocrine Surgery Entrustable Professional Activities

Area of Science:

• Surgical Education
• Medical Assessment
• Endocrine Surgery Training

Background:

• The American Association of Endocrine Surgeons (AAES) developed Entrustable Professional Activities (EPAs) for Endocrine Surgery (ES) to evaluate resident and fellow competence.
• This study investigates the agreement between learner self-assessments and faculty ratings of these ES EPAs.

Purpose of the Study:

• To assess the concordance between learner and teacher entrustability ratings for Endocrine Surgery EPAs.
• To identify discrepancies in self-assessment versus faculty evaluation within different phases of surgical care.

Main Methods:

• Fourteen EPAs were defined, including core and elective activities with single or multi-phase components.
• Ten institutions utilized web-based micro-assessments (MAs) with a five-point scale for observable behaviors.
• Learner self-ratings and separate teacher ratings were compared using Spearman rank correlation.

Main Results:

• A total of 698 MAs were collected between July 2022 and September 2023.
• Concordance between learner and teacher ratings varied by EPA phase: 32% (pre-op), 53% (intra-op), 29% (post-op), and 64% (single-phase).
• Overall Spearman correlation was 0.66, with highest correlation in the intra-operative phase (0.73) and lowest in the post-operative phase (0.20). Learners more often underestimated their performance.

Conclusions:

• Learner self-assessment and teacher ratings of endocrine surgery EPAs demonstrate strong concordance, particularly for operative technical skills.
• Discrepancies exist, with learners frequently underestimating their performance in pre- and post-operative care compared to faculty evaluations.