Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

Pugh, Debra; Cavalcanti, Rodrigo B.; Halman, Samantha; Mylopoulos, Maria; Shanks, David R.; Stroud, Lynfa

doi:10.4300/jgme-d-16-00282.1

Cited by 20 publications

(27 citation statements)

References 31 publications

(35 reference statements)

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“…importance that the longitudinal documentation and assessment of students' performance be informed by direct observation of students. 3,15,27,28,33,35,38,41 The second element that we frequently observed was the necessity that DPA be informed by a pre-established path of progression. 15,21,23,[25][26][27]30,[32][33][34][35][36][37][38][41][42][43][44][45][46][47][48][49][50][51][52]…”

Section: Theme 2: Sources Of Information For Dpamentioning

confidence: 95%

“…An underlying motivation to the implementation of DPA is to provide trainees and programmes with a report on trainees' progression and development given a specific established path of progression towards competency. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] In addition to providing a report on trainees' progression, DPA is expected to contribute to the development of better professionals by providing learning opportunities through assessment, feedback and guidance.…”

Section: Theme 1: Underlying Aims To Dpamentioning

confidence: 99%

“…22,25,29,30,32,37,47,49,[54][55][56]58,[62][63][64] In addition, several authors reported that the implementation of DPA provided the opportunity to identify trainees who require remediation. 22,27,29,30,36,38,43,52,54,55,63,65,66 Overall, the implementation of DPA was seen as an opportunity for better trainee assessment and programme evaluation. 30,39,41,46,47,49,54,55,58,[61][62][63][64][65]67 DPA was also seen as providing a means to monitor trainee progress and the development of their professional competency.…”

Section: Theme 5: Facilitatorsmentioning

confidence: 99%

“…30,39,41,46,47,49,54,55,58,[61][62][63][64][65]67 DPA was also seen as providing a means to monitor trainee progress and the development of their professional competency. [21][22][23][24]27,29,30,32,33,37,39,40,46,48,50,54,60,65,68 Lastly, DPA was seen the implementation didn't require it. 21,[23][24][25][26]30,33,49,54,55,[62][63][64]67 This is also seen as a strategy to give residents agency over their own professional development.…”

Section: Theme 5: Facilitatorsmentioning

confidence: 99%

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Lessons from the implementation of developmental progress assessment: A scoping review

et al. 2020

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Objectives Educators and researchers recently implemented developmental progress assessment (DPA) in the context of competency‐based education. To reap its anticipated benefits, much still remains to be understood about its implementation. In this study, we aimed to determine the nature and extent of the current evidence on DPA, in an effort to broaden our understanding of the major goals and intended outcomes of DPA as well as the lessons learned from how it has been executed in, or applied across, educational contexts. Methods We conducted a scoping study based on the methodology of Arksey and O’Malley. Our search strategy yielded 2494 articles. These articles were screened for inclusion and exclusion (90% agreement), and numerical and qualitative data were extracted from 56 articles based on a pre‐defined set of charting categories. The thematic analysis of the qualitative data was completed with iterative consultations and discussions until consensus was achieved for the interpretation of the results. Results Tools used to document DPA include scales, milestones and portfolios. Performances were observed in clinical or standardised contexts. We identified seven major themes in our qualitative thematic analysis: (a) underlying aims of DPA; (b) sources of information; (c) barriers; (d) contextual factors that can act as barriers or facilitators to the implementation of DPA; (e) facilitators; (f) observed outcomes, and (g) documented validity evidences. Conclusions Developmental progress assessment seems to fill a need in the training of future competent health professionals. However, moving forward with a widespread implementation of DPA, factors such as lack of access to user‐friendly technology and time to observe performance may render its operationalisation burdensome in the context of competency‐based medical education.

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Section: Theme 2: Sources Of Information For Dpamentioning

confidence: 95%

Section: Theme 1: Underlying Aims To Dpamentioning

confidence: 99%

Section: Theme 5: Facilitatorsmentioning

confidence: 99%

Section: Theme 5: Facilitatorsmentioning

confidence: 99%

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Lessons from the implementation of developmental progress assessment: A scoping review

et al. 2020

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“…It was hypothesized that novices would spend a higher percentage of time tracking the needle and ultrasound probe during these trials, while experts would spend more time focused on the ultrasound screen, because past research has shown that experts spend less time tooltracking than novices 22 . Senior residents, representative of a learner group that is often considered competent enough to perform the skill on patients with limited to no supervision 26 , were hypothesized to perform similarly to experts in this study.…”

Section: Rq2: Do Expert Senior Resident and Novice Gaze Patterns DImentioning

confidence: 99%

Looks can be deceiving: Gaze pattern differences between novices and experts during placement of central lines

Chen

Sonntag

Pepley

et al. 2019

The American Journal of Surgery

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Background: The objective of this study was to determine whether gaze patterns could differentiate expertise during simulated ultrasound-guided Internal Jugular Central Venous Catheterization (US-IJCVC) and if expert gazes were different between simulators of varying functional and structural fidelity. Methods: A 2017 study compared eye gaze patterns of expert surgeons (n=11), senior residents (n=4), and novices (n=7) during CVC needle insertions using the dynamic haptic robotic trainer (DHRT), a system which simulates US-IJCVC. Expert gaze patterns were also compared between a manikin and the DHRT. Results: Expert gaze patterns were consistent between the manikin and DHRT environments (p = 0.401). On the DHRT system, CVC experience significantly impacted the percent of time participants spent gazing at the ultrasound screen (p < 0.0005) and the needle and ultrasound probe (p < 0.0005). Conclusion: Gaze patterns differentiate expertise during ultrasound-guided CVC placement and the fidelity of the simulator does not impact gaze patterns.

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Faculty Entrustment and Resident Entrustability

Millar,

Matusko,

Evans

et al. 2024

JAMA Surg

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ImportanceAs the surgical education paradigm transitions to entrustable professional activities, a better understanding of the factors associated with resident entrustability are needed. Previous work has demonstrated intraoperative faculty entrustment to be associated with resident entrustability. However, larger studies are needed to understand if this association is present across various surgical training programs.ObjectiveTo assess intraoperative faculty-resident behaviors and determine if faculty entrustment is associated with resident entrustability across 4 university-based surgical training programs.Design, Setting, and ParticipantsThis cross-sectional study was conducted at 4 university-based surgical training programs from October 2018 to May 2022. OpTrust, a validated tool designed to assess both intraoperative faculty entrustment and resident entrustability behaviors independently, was used to assess faculty-resident interactions. A total of 94 faculty and 129 residents were observed. Purposeful sampling was used to create variation in type of operation performed, case difficulty, faculty-resident pairings, faculty experience, and resident training level.Main Outcomes and MeasuresObserved resident entrustability scores (scale 1-4, with 4 indicating full entrustability) were compared with reported measures (faculty level, case difficulty, resident postgraduate year [PGY], resident gender, observation month) and observed faculty entrustment scores (scale 1-4, with 4 indicating full entrustment). Path analysis was used to explore direct and indirect effects of the predictors. Associations between resident entrustability and faculty entrustment scores were assessed by pairwise Pearson correlation coefficients.ResultsA total of 338 cases were observed. Cases observed were evenly distributed by faculty experience (1-5 years’ experience: 67 [20.9%]; 6-14 years’ experience: 186 [58%]; ≥15 years’ experience: 67 [20.9%]), resident PGY (PGY 1: 28 [8%]; PGY 2: 74 [22%]; PGY 3: 64 [19%]; PGY 4: 40 [12%]; PGY 5: 97 [29%]; ≥PGY 6: 36 [11%]), and resident gender (female: 183 [54%]; male: 154 [46%]). At the univariate level, PGY (mean [SD] resident entrustability score range, 1.44 [0.46] for PGY 1 to 3.24 [0.65] for PGY 6; F = 38.92; P &lt; .001) and faculty entrustment (2.55 [0.86]; R2 = 0.94; P &lt; .001) were significantly associated with resident entrustablity. Path analysis demonstrated that faculty entrustment was associated with resident entrustability and that the association of PGY with resident entrustability was mediated by faculty entrustment at all 4 institutions.Conclusions and RelevanceFaculty entrustment remained associated with resident entrustability across various surgical training programs. These findings suggest that efforts to develop faculty entrustment behaviors may enhance intraoperative teaching and resident progression by promoting resident entrustability.

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Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

Abstract: Background The entrustable professional activity (EPA) framework has been identified as a useful approach to assessment in competency-based education. To apply an EPA framework for assessment, essential skills necessary for entrustment to occur must first be identified.

Cited by 20 publications

References 31 publications

Lessons from the implementation of developmental progress assessment: A scoping review

Lessons from the implementation of developmental progress assessment: A scoping review

Looks can be deceiving: Gaze pattern differences between novices and experts during placement of central lines

Faculty Entrustment and Resident Entrustability

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