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Related Experiment Video

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Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults
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Entrustment Signal Distortion: Addressing Specialty Misalignment in Entrustable Professional Activity Assessment of

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  • 1Department of Surgery, Oregon Health & Science University, Portland, Oregon.

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|March 31, 2026
PubMed
Summary
This summary is machine-generated.

Entrustable professional activities (EPAs) show significant engagement disparities across surgical specialties, indicating a need for framework revisions. This variability may misrepresent faculty teaching and resident competency in certain fields.

Keywords:
AssessmentCompetency-based educationEPA engagementEntrustable professional activitiesSpecialty variationSurgical education

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Area of Science:

  • Surgical Education
  • Competency-Based Medical Education
  • Assessment Tools

Background:

  • Entrustable professional activities (EPAs) are key for competency-based surgical education.
  • Variations in EPA implementation and engagement across specialties can skew trainee competency signals.

Purpose of the Study:

  • To evaluate EPA assessment patterns across surgical specialties.
  • To identify structural misalignments in the current EPA framework.

Main Methods:

  • Retrospective analysis of EPA evaluations from the Firefly Platform (July 2023-July 2025).
  • Inclusion of 650 faculty from 46 institutions, with specialty confirmation.
  • Calculation of EPA assessment rates stratified by care phase (preoperative, intraoperative, postoperative).
  • Statistical comparison using Kruskal-Wallis and Dunn's tests with Bonferroni correction.

Main Results:

  • Significant variation in EPA engagement by specialty (P < 0.0001).
  • Highest engagement in hepatopancreatobiliary and trauma/acute care surgery; lowest in plastic and vascular surgery.
  • Concentrated participation noted, with top 10% of faculty submitting 60.8% of EPAs.

Conclusions:

  • Disparities in EPA engagement suggest specialty-specific structural misalignments.
  • Low engagement fields may underrepresent faculty teaching and resident competency.
  • Revisions to the EPA framework are necessary for improved fairness and fidelity across specialties.