Faculty Barriers to Completing Entrustable Professional Activity Evaluations And Providing Narrative Feedback

To determine faculty perceptions of feedback delivery, EPA completion, and narrative feedback provision. To evaluate barriers to EPA completion and narrative feedback, as well as potential solutions to these barriers.

A survey was sent to surgical faculty that asked about feedback delivery, EPA completion, and barriers to completion of EPAs or narrative feedback. Both free response and multiple-choice questions regarding barriers were included. Faculty responses were analyzed for perception of feedback completion verbally and through EPAs. Inductive thematic analysis was performed for free response questions regarding barriers to EPA completion and possible solutions.

Two large, academic general surgery residency programs.

Faculty at two academic institutions who work with general surgery residents and complete EPA evaluations.

Survey response rate was 57.9%. Most surgeons participating were male (68.8%) and had been in practice at least 20 years (37.1%). Faculty reported providing verbal intraoperative feedback a median of 91.5%, but only completing EPAs a median of 25% of the time. They reported providing EPA narrative feedback a median of 50% of the time. The greatest barriers to EPA completion were reported as lack of resident requests for EPAs and completion not being within their normal workflow. Barriers to providing narrative feedback within the EPA were time and lack of clear benefit to the feedback. Possible solutions to combat these barriers were improvements to the EPA evaluation app to include a better user interface, reminders, or incorporating prior verbal intraoperative feedback and encouraging residents to take ownership of EPA requests.

Faculty report frequently providing verbal intraoperative feedback, but report completing EPAs and narrative feedback much less often. Implementation should focus on enhancing EPA evaluation apps to improve functionality and providing incentives to make EPA completion a habit and worthwhile use of faculty time.