Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 1;96(7S):S70-S75.
doi: 10.1097/ACM.0000000000004090.

Validity Evidence for Assessing Entrustable Professional Activities During Undergraduate Medical Education

Claudio Violato  1 , Michael J Cullen  2 , Robert Englander  3 , Katherine E Murray  4 , Patricia M Hobday  5 , Emily Borman-Shoap  6 , Ozge Ersan  7
Affiliations

Validity Evidence for Assessing Entrustable Professional Activities During Undergraduate Medical Education

Claudio Violato et al. Acad Med. .

Abstract

Purpose: To explore validity evidence for the use of entrustable professional activities (EPAs) as an assessment framework in medical education.

Method: Formative assessments on the 13 Core EPAs for entering residency were collected for 4 cohorts of students over a 9- to 12-month longitudinal integrated clerkship as part of the Education in Pediatrics Across the Continuum pilot at the University of Minnesota Medical School. The students requested assessments from clinical supervisors based on direct observation while engaging in patient care together. Based on each observation, the faculty member rated the student on a 9-point scale corresponding to levels of supervision required. Six EPAs were included in the present analyses. Student ratings were depicted as curves describing their performance over time; regression models were employed to fit the curves. The unit of analyses for the learning curves was observations rather than individual students.

Results: (1) Frequent assessments on EPAs provided a developmental picture of competence consistent with the negative exponential learning curve theory; (2) This finding was true across a variety of EPAs and across students; and (3) The time to attain the threshold level of performance on the EPA for entrustment varied by student and EPA.

Conclusions: The results provide validity evidence for an EPA-based program of assessment. Students assessed using multiple observations performing the Core EPAs for entering residency demonstrate classic developmental progression toward the desired level of competence resulting in entrustment decisions. Future work with larger data samples will allow further psychometric analyses of assessment of EPAs.

PubMed Disclaimer

References

    1. Carraccio C, Englander R, Gilhooly J, et al. Building a framework of entrustable professional activities, supported by competencies and milestones, to bridge the educational continuum. Acad Med. 2017; 92:324–330.
    1. Violato C. Assessing Competence in Medicine and Other Health Professions. New York, NY: Taylor & Francis; 2019.
    1. ten Cate O, Scheele F. Competency-based postgraduate training: Can we bridge the gap between theory and clinical practice? Acad Med. 2007; 82:542–547.
    1. Englander R, Frank JR, Carraccio C, Sherbino J, Ross S, Snell L; ICBME Collaborators. Toward a shared language for competency-based medical education. Med Teach. 2017; 39:582–587.
    1. Englander R, Flynn T, Call S, et al. Toward defining the foundation of the MD degree: Core entrustable professional activities for entering residency. Acad Med. 2016; 91:1352–1358.