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Learning Analytics of a National Entrustable Professional Activities Platform: Cross-Sectional Study of System-Level
Jeng-Wen Chen1,2,3, Rui-Bin Yu4,5, Kai-Nan Lin1,2
1Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Competency-based medical education (CBME) shows a gap in expected trainee autonomy, particularly in later years. System design, not just trainees, influences this, offering opportunities for improvement.
Area of Science:
- Medical Education
- Learning Analytics
- Healthcare Systems
Background:
- Competency-based medical education (CBME) utilizes entrustable professional activities (EPAs) and Clinical Competency Committee (CCC) reviews for trainee progression.
- Digital assessment platforms aggregate data, enabling learning analytics to reveal insights into entrustment decisions within CBME.
- Understanding how national assessment infrastructures impact entrustment attainment is crucial but underexplored.
Purpose of the Study:
- To analyze national CCC summative entrustment decisions.
- To identify system-level factors linked to expected supervision level attainment in residency training.
Main Methods:
- Cross-sectional analysis of nationwide CCC entrustment data from the Emyway platform in Taiwan.
- Included 3504 decisions across 12 EPAs for 292 otolaryngology residents.
- Logistic regression identified factors associated with expected supervision attainment, including training stage, EPA sequencing, and CCC review frequency.
Main Results:
- Supervision levels increased with training but often fell short of targets in senior years (R4-R5).
- Expected targets were met in 73% of decisions, with underattainment common in later stages.
- Delayed EPA sequencing and less frequent CCC reviews were linked to lower attainment.
Conclusions:
- Learning analytics reveal a consistent gap in trainee autonomy in later CBME stages.
- Assessment system design, including EPA sequencing and CCC governance, significantly impacts entrustment outcomes.
- National data benchmarking offers actionable insights for optimizing CBME systems.
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