59. FELLOW SELF ASSESSMENT USING THE PEDIATRIC SUBSPECIALITY EPAS

Abstract

Background As an alternative to milestone based evaluations, Entrustable Professional Activities (EPAs) may provide a more specific and useful feedback tool for fellow training. Assigning a level of entrustment on an EPA coupled with qualitative comments, shows promise as a real-time feedback approach. Although the EPAs are being studied as a summative assessment tool in fellowship training, their formative assessment capabilities remain unknown. In addition, fellows self-assessment on EPAs has not been well-studied. Methods As part of a pilot study, we created an online EPA assessment form. Pediatric fellows from four divisions (Neonatology, Endocrinology, Adolescent Medicine, and Developmental and Behavioral Pediatrics) were recruited. As part of a needs assessment on feedback in fellowship training, the participating fellows were asked to provide self-assessment via the 6 core pediatric subspecialty EPAs using the established scoring benchmarks. Results Nine fellows completed the needs assessment survey: 3 first year, 4 second year, and 2 third year fellows. Lead Subspecialty had the lowest average score of 2.78, with Handovers having the highest average score of 3.67. Fellows rated themselves as trusted to practice without supervision for Fiscal Management and Handovers, whereas fellows at all levels of training rated themselves as needing at least indirect supervision for the EPAs related to Consultation, Public Health, and Lead Team. Conclusions Our pilot establishes preliminary data of where fellows feel their level of entrustment is at the beginning of the academic year. Variability in self-assessment may be related to unfamiliarity with the rating scale, true variation in fellow skillset, or may represent re-appraisal of skills as fellows advance in development. Use of the EPA assessment scale and more frequent assessments we hope will increase familiarity with EPA scale and improve fellows’ ability to reflect on development. Fellows self-reported need for at least indirect supervision on most EPAs highlights the need for ongoing coaching and supervision throughout all three years of training.