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

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.