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The American Board of Surgery (ABS) now requires entrustable professional activities (EPAs) for general surgery residents. Successful implementation requires addressing local factors and driving faculty and trainee engagement for competency-based education.

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Area of Science:

  • Medical Education
  • Surgical Training
  • Competency-Based Education

Background:

  • The American Board of Surgery (ABS) has adopted an assessment framework using entrustable professional activities (EPAs) for general surgery residency programs.
  • Eighteen general surgery EPAs were implemented in July 2023, requiring graduates seeking board certification from 2028 onwards to submit EPA assessment profiles.

Purpose of the Study:

  • To assess the initial implementation and identify challenges in the EPA-based assessment framework for general surgery residencies.
  • To provide strategies for program leadership to enhance engagement and optimize the use of EPA data.

Main Methods:

  • Analysis of hundreds of thousands of EPA assessments collected over nearly two years in general surgery residencies.
  • Review of factors influencing performance variability and challenges in faculty and trainee engagement.

Main Results:

  • Significant variability in performance exists across programs, influenced by local factors like resources and structure.
  • Consistent engagement from faculty and trainees remains a key challenge for successful EPA implementation.

Conclusions:

  • Successful implementation of EPAs is contingent upon local program factors, including structure, resources, and practice patterns.
  • Program leadership support is crucial for driving culture change and fostering engagement with EPA assessments.
  • Strategies for generating buy-in, optimizing feedback, and motivating engagement are essential for maximizing the benefits of EPAs.