Abstract
BackgroundCore Entrustable Professional Activities (EPAs) have been defined to specify the performance expectations for entering residents worldwide. The content of these EPAs was elaborated and validated primarily via medical expert consent approaches. The present study aims to collect empirical information on the actual task performance and supervision level of entering residents as a complementary methodological approach to enhance the content validity of a set of institutional EPAs.MethodsIn the summers of 2017 and 2018, Charité medical graduates (n = 720) received a post-graduation survey by mail. The questionnaire covered the performance of Core EPAs, Core procedures and more advanced EPAs. Graduates were asked how frequently they had performed the respective EPAs since the start of residency and under what level of supervision. We expected the large majority of graduates (> 75%) to have performed the Core EPAs and procedures under at least indirect supervision.ResultsIn total, 215 graduates (30%) returned the questionnaire, and 131 (18%) surveys could be included in the data analysis. The majority of participants were female (63%) and worked in hospitals (50%) or in university medical centres (30%) across various medical disciplines. Among the Core EPAs, 10 out of 11 tasks had been performed by more than 75% of graduates since the start of residency, 9 under indirect supervision. Regarding the Core procedures, only 3 out of 13 procedures had been performed by the large majority of graduates under indirect supervision, and 10 procedures had not been carried out by at least one-third of participants. Among the 5 advanced EPAs, none of 5 had been performed by more than 75% of the participants since the start of residency, and 4 had been carried out by 50% under indirect supervision.ConclusionsThe results of this study largely and complementarily confirm the validity of the defined Core EPAs representing realistic expectations for entry into residence at our institution. The low actual performance rate of Core procedures serves to stimulate an institutional discussion on their adjustment to better match the workplace reality.
Highlights
Core Entrustable Professional Activities (EPAs) have been defined to specify the performance expectations for entering residents worldwide
The content elaboration and validation of such Core EPAs did not involve explicit empirical data or research on the tasks entering residents perform. Such real-world data from clinical workplaces could be used for triangulation of the performance expectations with experts’ opinions by providing complementary evidence of their content validity or, in the case of divergence, an opportunity for the re-adjustment of the Core EPAs
The results show that the majority of residents show high confidence, identifying only a few EPAs that the majority do not feel safe to perform without direct supervision
Summary
Core Entrustable Professional Activities (EPAs) have been defined to specify the performance expectations for entering residents worldwide The content of these EPAs was elaborated and validated primarily via medical expert consent approaches. The present study aims to collect empirical information on the actual task performance and supervision level of entering residents as a complementary methodological approach to enhance the content validity of a set of institutional EPAs. Entry into residency is characterized by a sudden and often overwhelming increase in responsibilities for graduating physicians with respect to the care of patients. The content elaboration and validation of such Core EPAs did not involve explicit empirical data or research on the tasks entering residents perform. The idea behind the EPA concept is to define those tasks trainees are commonly expected to perform at the end of a training phase without supervision and to implement these as outcomes for the curriculum
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