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Pediatric Residents' Readiness for Practice and Performance on the Initial Certifying Examination.

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Entrustable Professional Activity (EPA) assessments at the end of pediatric residency do not strongly predict success on the general pediatrics certifying exam. Further integration is needed for competency-based training and certification.

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Area of Science:

  • Medical Education
  • Pediatric Residency Training
  • Competency-Based Assessment

Background:

  • Clinical competency committees use Entrustable Professional Activities (EPAs) to assess resident readiness for unsupervised practice.
  • The relationship between EPA-based readiness assessments and performance on the general pediatrics initial certifying examination is not well understood.

Purpose of the Study:

  • To examine the correlation between EPA-based assessments by clinical competency committees and performance on the general pediatrics initial certifying examination.
  • To evaluate if residents deemed ready for unsupervised practice based on EPAs perform better on board certification exams.

Main Methods:

  • Data from 21 pediatric residency programs (2015-2018) on EPA readiness were linked with American Board of Pediatrics Initial Certifying Exam scores.
  • Residents' exam performance was compared between those deemed ready for unsupervised practice across all EPAs and those not.

Main Results:

  • 91% of 934 graduates passed the initial certifying exam on their first attempt.
  • Of those who passed, 61% were deemed ready for unsupervised practice, while 39% were not.
  • Among those who failed the exam, 52% were deemed ready for unsupervised practice, and 48% were not.

Conclusions:

  • EPA-based practice readiness assessments show a weak correlation with passing general pediatrics board certification exams.
  • These assessments and board exams measure different, though overlapping, essential components of pediatric care.
  • Further research is required to integrate competency-based approaches using diverse data sources for informed decisions on resident readiness and educational needs.