Abstract
Background Compared to semi-annual Milestone-based assessment models of fellowship training, Entrustable Professional Activities (EPAs) may be better at assessing fellow development. EPAs' formative assessment capabilities are unknown, nor have they been adopted as a method for evaluation. The use of EPAs' entrustment scales could allow for more specific, actionable feedback from faculty during training. Methods In a pilot study, we created a needs assessment on feedback in pediatric fellowship training and a readily accessible online EPA assessment form. Fellows use the form to ask faculty to choose EPAs to assess following a clinical experience. Fellows from Neonatology, Endocrinology, Adolescent Medicine, and Developmental & Behavioral Pediatrics were recruited. Fellows are asked to obtain a minimum of four EPA assessments monthly. Time spent completing forms and providing feedback is recorded for each encounter. Results 20 faculty, 4 program directors and 9 fellows completed the needs assessment. 77% of fellows reported current Milestone-based feedback aided their professional development, but only 60% were satisfied with the quantity and quality of feedback received. 80% of faculty believed fellows were provided adequate feedback using Milestones, but only 50% reported they provided good feedback. Faculty identified many barriers to giving good feedback using Milestones. 85% felt use of a structured EPA template and more frequent opportunities would improve their feedback. In the first 4 months of the pilot, 27 episodes of EPA based feedback occurred. 12 different faculty members have provided feedback using the template. The most often used EPA was Lead Team while Public Health was least used. An average of 9 minutes of feedback per assessment was reported. Conclusions Our pediatric faculty and fellows feel an opportunity exists to improve the quality and quantity of feedback from our current Milestone approach. An online EPA tool is being used by faculty and fellows to provide more frequent feedback. Future assessments will evaluate the utility and specificity of feedback provided.
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