Implementation of a Workplace-Based Assessment System to Measure Performance of the Core Entrustable Professional Activities in the Pediatric Clerkship.

Abstract

The Core Entrustable Professional Activities for Entering Residency (Core EPAs) were developed to address the gap between medical school and residency. There is a lack of instruments to measure performance of the Core EPAs in clerkships. We describe the operationalization and outcomes of a workplace-based assessment (WBA) system to measure performance of the Core EPAs in the pediatrics clerkship. A mobile-friendly WBA was developed at the authors' institution. The WBA incorporated a modified version of the Ottawa Clinic Assessment Tool (OCAT), an instrument that rates performance on a scale of 1 to 4 (1- "I had to do it" to 4- "I had to be there just in case"). During 2018 to 2019, all students were required to request feedback for 6 of the 13 Core EPAs using the WBA in the Pediatrics clerkship. Descriptive and inferential statistics were calculated to assess mean OCAT scores, variance in performance and correlation between scores, clerkship timing, and grades. Total 1655 WBAs were completed for 218 students. The overall mean OCAT score was 3.47 out of 4. Scores across Core EPAs were greater in later rotations (r=0.157, P< .001). One-way analysis of variance revealed significant variance on score by student, assessor, and timing of clerkship block. Final grades were correlated with OCAT scores (Spearman's ρ=0.25, P < .001). The results of this study demonstrate initial outcomes for a WBA system to assess performance for the Core EPAs in pediatrics using the OCAT scale. Future studies will assess the system across clerkships.