Entrustable Professional Activities Beyond Engagement: Best Practices From Across the Training Continuum

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.