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Development of Nested Entrustable Professional Activities: A Delphi Consensus Study in General Surgery.

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Summary
This summary is machine-generated.

Nested Entrustable Professional Activities (EPAs) offer a granular assessment framework for mid-level surgical residents. This model enhances the evaluation of incremental progress and learner development in medical education.

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Area of Science:

  • Medical Education
  • Surgical Training Assessment

Background:

  • Current Entrustable Professional Activities (EPAs) often assess skills for later training stages, failing to capture mid-level resident progression.
  • This limits granular assessment, impacting resident motivation and early identification of struggling learners.

Purpose of the Study:

  • To develop and describe a framework of nested EPAs for surgical training.
  • To establish a reproducible model for assessing mid-level resident competency across medical specialties.

Main Methods:

  • A systematic process generated 160 narratives for 10 nested EPAs across 4 performance domains and 4 autonomy levels.
  • A Delphi consensus study with 15 surgical experts finalized the nested EPAs and narratives, achieving 80% agreement.

Main Results:

  • The initial Delphi round achieved 85% consensus on 136 items.
  • A second round achieved 100% consensus on all 41 revised items, confirming the framework's viability.

Conclusions:

  • A novel framework for developing nested EPAs was successfully demonstrated.
  • This model provides a granular approach to assessing trainee progression in medical education.