Objective: Concerns over resident ability to practice effectively after graduation have led to the competency-based medical education movement. Entrustable professional activities (EPAs) may facilitate competency-based medical education in surgery, but implementation is challenging. This manuscript describes 1 strategy used to implement EPAs into an academic general surgery residency.
Design, Setting, Participants: A mobile application was developed incorporating 5 EPAs developed by the American Board of Surgery; residents and faculty from the Departments of Surgery, Emergency Medicine, and Hospital Medicine at a single tertiary care center were trained in its use. Entrustment levels and free text feedback were collected. Self-assessment was paired with supervisor assessment, and faculty assessments were used to inform clinical competency committee entrustment decisions. Feedback was regularly solicited from app users and results distributed on a monthly basis.
Results: One thousand seven hundred and twenty microassessments were collected over the first 16 months of implementation; 898 (47.8%) were performed by faculty with 569 (66.0%) matched pairs. Engagement was skewed with small numbers of high performers in both resident and faculty groups. Continued development of resident and faculty was required to sustain engagement with the program. Nonsurgical specialties contributed significantly to resident assessments (496, 28.8%).
Conclusions: EPAs are being successfully integrated into the assessment framework at our institution. EPA implementation in surgery residency is a long-term process that requires investment, but may address limitations in the current assessment framework.
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http://dx.doi.org/10.1016/j.jsurg.2020.01.012 | DOI Listing |
Rev Col Bras Cir
January 2025
- Universidade de São Paulo, Anestesiologia - São Paulo - SP - Brasil.
We discuss the arguments exposed in the Letter to the Editor "Reflections on the Inclusion of Direct-Care Physicians as Educators in Community Hospitals", exploring the teaching competencies necessary for community preceptors in the context of medical education, highlighting the growing responsibility of these professionals in the training of future physicians in health-deprived regions. From a narrative review, we analyze faculty development (FD) programs, emphasizing their importance in improving teaching skills, creating support networks, and providing personalized content for specific challenges. Among the competence domains identified are teaching skills, evaluation criteria, professionalism, communication, and leadership/management.
View Article and Find Full Text PDFJ Dent Sci
December 2024
Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and Fu Jen Catholic University, New Taipei City, Taiwan.
Background/purpose: This study aimed to evaluate the initial implementation of competency-based medical education (CBME) through entrustable professional activities (EPAs) in Taiwan dental education, focusing on tooth extraction EPAs across undergraduate year (UGY), postgraduate year (PGY), and oral and maxillofacial surgery-residency (OS-R) levels.
Materials And Methods: Using the Delphi method, an advisory team developed and validated three levels of trial EPAs, which were implemented through the Emyway platform. A structured questionnaire was used to evaluate teachers' and students' experiences and satisfaction with Emyway and the EPAs.
J Surg Educ
January 2025
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri; John Cochran VA Medical Center, St. Louis, Missouri.
Objective: Identify changes in general surgery resident autonomy and resident postgraduate year (PGY) level in Entrustable Professional Activity (EPA) cases over time.
Design: Retrospective cohort study.
Setting: United States Veterans Affairs (VA) hospital system, 2004 to 2020.
Ann Surg
January 2025
Department of Surgery, University of Alabama at Birmingham.
The magnitude of advances in surgical care inspires awe consistent with the impact of these developments on patients' lives. With this comes greater knowledge, new practices, and novel technologies for integration into residency training, making the skillset required of today's residents quite different from those in the past. Competency-based medical education and learner-centered approaches offer innovative and studied methodologies for teaching, learning, and assessment to meet the demands of today's educational environment.
View Article and Find Full Text PDFIn this article, the authors propose a repurposing of the concept of entrustment to help guide the use of artificial intelligence (AI) in health professions education (HPE). Entrustment can help identify and mitigate the risks of incorporating generative AI tools with limited transparency about their accuracy, source material, and disclosure of bias into HPE practice. With AI's growing role in education-related activities, like automated medical school application screening and feedback quality and content appraisal, there is a critical need for a trust-based approach to ensure these technologies are beneficial and safe.
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