Implications of Entrustable Professional Activities for Motivation and Learning.

Abstract

This study sought to explore the experience of entrustable professional activity-based assessment and its effect on self-determination, a well-supported measure of motivation. The goal was to understand EPA-based assessment's implications for student motivation, learning, and wellbeing. A qualitative case study design was utilized through a standardized simulation activity with EPA-based assessment. An analysis of interviews and reflection journals was completed by the coding of emergent themes and significant statements with a subsequent thematic analysis framed in self-determination theory (SDT). Entrustment was found to be an affectively and interpersonally impactful metric that provided the learner with a clear understanding of clinical performance. Quality entrustment feedback supported participants' sense of competence and increased their confidence in their ability to be autonomous as well as a valuable part of the healthcare team. EPAs appeared to support learners' sense of competence and to provide a bridge to support autonomy and the ability to relate to others. To the extent that entrustment supported learners' sense of competence, other SDT propositions could be subsequently bolstered as well. Self-determination and intrinsic motivation were uniquely supported by EPA-based assessment, if implemented effectively. Further research is needed to better define effective implementation, faculty development, and feedback strategies.