Competency-based Education Model Research Articles

Advancing Nursing Practice: The Evolution and Impact of Continuing Professional Development.

American Nurses Credentialing Center (ANCC) Accreditation in Nursing Continuing Professional Development (NCPD) emphasizes the importance of maintaining competence, ensuring patient safety, and supporting career advancement in nursing through learning and development. It underscores the shift toward competency-based and outcome-oriented education models, addressing challenges such as misconceptions about the demands of NCPD and focusing more on the impact. This column provides the "why" for organizations, leaders, and nurses to engage in ANCC accredited NCPD educational programs. It further explores a future where NCPD fosters a skilled, equitable, and diverse health care workforce, promoting transformational learning experiences. [J Contin Educ Nurs. 2024;55(4):153-156.].

Competence By Design: a transformational national model of time-variable competency-based postgraduate medical education.

Postgraduate medical education is an essential societal enterprise that prepares highly skilled physicians for the health workforce. In recent years, PGME systems have been criticized worldwide for problems with variable graduate abilities, concerns about patient safety, and issues with teaching and assessment methods. In response, competency based medical education approaches, with an emphasis on graduate outcomes, have been proposed as the direction for 21st century health profession education. However, there are few published models of large-scale implementation of these approaches. We describe the rationale and design for a national, time-variable competency-based multi-specialty system for postgraduate medical education called Competence by Design. Fourteen innovations were bundled to create this new system, using the Van Melle Core Components of competency based medical education as the basis for the transformation. The successful execution of this transformational training system shows competency based medical education can be implemented at scale. The lessons learned in the early implementation of Competence by Design can inform competency based medical education innovation efforts across professions worldwide.

AI in medical education: uses of AI in construction type A MCQs

BackgroundThe introduction of competency-based education models, student centers, and the increased use of formative assessments have led to demands for high-quality test items to be used in assessments. This study aimed to assess the use of an AI tool to generate MCQs type A and evaluate its quality.MethodsThe study design was cross-sectional analytics conducted from June 2023 to August 2023. This study utilized formative TBL. The AI tool (ChatPdf.com) was selected to generate MCQs type A. The generated items were evaluated using a questionnaire for subject experts and an item (psychometric) analysis. The questionnaire to the subject experts about items was formed based on item quality and rating of item difficulty.ResultsThe total number of recurrent staff members as experts was 25, and the questionnaire response rate was 68%. The quality of the items ranged from good to excellent. None of the items had scenarios or vignettes and were direct. According to the expert’s rating, easy items represented 80%, and only two had moderate difficulty (20%). Only one item out of the two moderate difficulties had the same difficulty index. The total number of students participating in TBL was 48. The mean mark was 4.8 ± 1.7 out of 10. The KR20 is 0.68. Most items were of moderately difficult (90%) and only one was difficult (10%). The discrimination index of the items ranged from 0.77 to 0.15. Items with excellent discrimination represented 50% (5), items with good discrimination were 3 (30%), and only one time was poor (10%), and one was none discriminating. The non-functional distractors were 26 (86.7%), and the number of non-functional distractors was four (13.3%). According to distractor analysis, 60% of the items were excellent, and 40% were good. A significant correlation (p = 0.4, r = 0.30) was found between the difficulty and discrimination indices.ConclusionItems constructed using AI had good psychometric properties and quality, measuring higher-order domains. AI allows the construction of many items within a short time. We hope this paper brings the use of AI in item generation and the associated challenges into a multi-layered discussion that will eventually lead to improvements in item generation and assessment in general.

Pedagogical Strategy Based on the Application of Design Thinking Techniques for the Teaching-Learning Process of Research Methodologies in Psychology Students of the Technical Corporation for Human, Social and Cultural Development of Colombia- CORPODESC, 2023

This master's thesis was born as a commitment to improve the training processes of university students around the teaching of research methodologies; thus creating a new way of bringing knowledge of the scientific method to students in a dynamic, creative, practical and innovative way. This exercise was carried out at the Technical Corporation for Human, Social and Cultural Development of Colombia (Corpodesc), specifically in its psychology program that is implemented through virtual education; The main objective of this work was to develop a pedagogical strategy based on the application of design thinking techniques for the teaching- learning process of research methodologies in psychology students at Corpodesc. To carry out this process, different theoretical components were taken into account, such as the conceptualization of design thinking and the design thinking model for educators, as well as those related to the competency-based educational model for professional training. To operationalize this research project, it was framed under the interpretative paradigm with a qualitative approach; using the practical design type of participatory action research. The sample consisted of 18 seventh-semester psychology students in virtual mode who were taking the subject of 'research methods in psychology'; all of whom participated in the strategy designed. For data collection, the 'Scale to Measure Attitudes towards Research (EACIN)2 was selected in the diagnosis, and a structured interview was applied for the evaluation. Among the main results of the study with respect to the diagnosis was that a significant percentage of the students had a level of favorability around research, although their main deficiencies were around procrastinating as much as possible the activities related to research or having little culture of reading research papers. Regarding the evaluation of the strategy, what can be highlighted is that the students stated that the teaching of research methodologies under the conception of design thinking made it much more practical, dynamic, innovative, interesting and much easier for them to integrate the theoretical with the pragmatic aspects of the research. It is concluded from this whole process that the design thinking methodology does have the capacity to be adapted to the teaching-learning processes of research methodologies at the undergraduate level, however, it is important to carry out more studies that allow a differentiation of effectiveness between this way of teaching and the traditional way.

Understanding Teacher’s Agency in the Implementation of a Competency-Based Language Teaching (CBLT) program.

This qualitative case study aims to analyze teacher agency within the context of the Competency-Based Education Model (CBLT) model. The primary objective is to shed light on how teachers negotiate this model within their classrooms and the ensuing dynamics stemming from the top-down policy implementation. Data collection involved semi-structured interviews, classroom observations, and the compilation of student learning outcomes.

A Call to Shift to Competency-Based Education

Abstract This column explores the concept of competency-based education (CBE). A shift to CBE is a key trend for the future of health care education. Health care professions that have adopted, or started to adopt, a CBE framework include physical therapy, speech-language pathology, social work, medicine, nursing, pharmacology, and dentistry. Internationally, many occupational therapy programs are in the process of shifting to, or have shifted to, a CBE model. This column discusses how although select occupational therapy programs in the United States may individually be considering shifting to, or have shifted to, a CBE framework, there is no national movement to explore adopting the model for occupational therapy or a consensus on defined outcomes for the profession.

Implementing Competency-Based Veterinary Education: A Survey of AAVMC Member Institutions on Opportunities, Challenges, and Strategies for Success

Competency-based education is increasingly being adopted across the health professions. A model for competency-based education in veterinary medicine was recently developed by a working group of the American Association of Veterinary Medical Colleges (AAVMC) and is being used in institutions worldwide. The purpose of this study was to gather information on progress in and barriers to implementing competency-based education (including use of the AAVMC competency-based veterinary education [CBVE] Model) by AAVMC member schools to inform the development of strategies to support institutions in successful implementation of the CBVE Model. A cross-sectional survey was developed and distributed to AAVMC member institutions via an AAVMC web-based communication platform. Thirty-four of 55 AAVMC member institutions responded to the survey (62% response rate). Twenty schools reported using a competency-based education framework. Eleven of these institutions had implemented the AAVMC CBVE Framework, with an additional 12 institutions anticipating implementing it over the next 3 years. Timing, resources, and change management were the most commonly reported challenges to implementation. Suggestions for development of training resources included translation of milestones to pre-clinical courses, development of assessments, guidance on making progress decisions, illustrative overviews of specific components of the CBVE Model (e.g., the AAVMC CBVE Framework, EPAs, entrustment scales, milestones), and curriculum mapping. This study assesses progress in implementing the CBVE Model in AAVMC member schools and aids in identifying key challenges and resources to support faculty and institutions in the successful adoption and implementation of this educational model.

Is the Competency-Based Education Model Effective in Otolaryngology Training?

Is the Competency-Based Education Model Effective in Otolaryngology Training?

Activating the American Association of Colleges of Nursing Essentials Through Competency-Based Leadership in Graduate Student Organizations.

As nursing programs across the nation shift toward a competency-based education model, academic institutions are working to quantify student learning outcomes based on the new American Association of Colleges of Nursing (AACN, 2021) Essentials, domains, competencies, and sub-competencies. Leveraging AACN Essentials, faculty and graduate nursing students engage in student organizations with the focus of Population Health, Professionalism, and Personal, Professional and Leadership Development (AACN, 2021). Graduate student members are involved in practicum activities throughout the course of their education. Through collaboration with faculty, the student body, and other community partners, student leaders integrate experiences applicable to professional roles outside of academia (AACN, 2021). As a result, students gain skills in leadership and communication, while also gaining confidence and professional identity formation. Other academic institutions may replicate this approach in promoting competency-based education, experiences and development in alignment with the AACN Essentials. [J Nurs Educ. 2023;62(10):580-583.].

Competency-Based Cultural Safety Training in Medical Education at La Sabana University, Colombia: A Roadmap of Curricular Modernization

Issue: Cultural safety enhances equitable communication between health care providers and cultural groups. Most documented cultural safety training initiatives focus on Indigenous populations from high-income countries, and nursing students, with little research activity reported from low- and middle-income countries. Several cultural safety training initiatives have been described, but a modern competency-based cultural safety curriculum is needed. Evidence: In this article, we present the Competency-Based Education and Entrustable Professional Activities frameworks of the Faculty of Medicine at La Sabana University in Colombia, and illustrate how this informed modernization of medical education. We describe our co-designed cultural safety training learning objectives and summarize how we explored its impact on medical education through mixed-methods research. Finally, we propose five cultural safety intended learning outcomes adapted to the updated curriculum, which is based on the Competency-Based Education model. Implications: This article presents five cultural safety intended learning outcomes for undergraduate medical education. These learning outcomes are based on Competency-Based Education and the Entrustable Professional Activities framework and can be used by faculties of medicine interested in including the cultural safety approach in their curriculum.

Competency-Based Time-Variable Anesthesiology Residency Training: Identification of Problems and Solutions.

Global medical education is gradually moving toward more comprehensive implementations of a competency-based education (CBE) model. Elimination of standard time-based training and adoption of time-variable training (competency-based time-variable training [CB-TVT]) is one of the final stages of implementation of CBE. While CB-TVT has been implemented in some programs outside the United States, residency programs in the United States are still exploring this approach to training. The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) are encouraging member boards and residency review committees to consider innovative ways programs could implement CB-TVT. The goals of this study were to (1) identify potential problems with the implementation of CB-TVT in anesthesiology residency training, (2) rank the importance of the problems and the perceived difficulty of solving them, and (3) develop proposed solutions to the identified problems. Study participants were recruited from key stakeholder groups in anesthesiology education, including current or former program directors, department chairs, residents, fellows, American Board of Anesthesiology (ABA) board members, ACGME residency review committee members or ACGME leaders, designated institutional officials, residency program coordinators, clinical operations directors, and leaders of large anesthesiology community practice groups. This study was conducted in 2 phases. In phase 1, survey questionnaires were iteratively distributed to participants to identify problems with the implementation of CB-TVT. Participants were also asked to rank the perceived importance and difficulty of each problem and to identify relevant stakeholder groups that would be responsible for solving each problem. In phase 2, surveys focused on identifying potential solutions for problems identified in phase 1. A total of 36 stakeholders identified 39 potential problems, grouped into 7 major categories, with the implementation of CB-TVT in anesthesiology residency training. Of the 39 problems, 19 (48.7%) were marked as important or very important on a 5-point scale and 12 of 19 (63.2%) of the important problems were marked as difficult or very difficult to solve on a 5-point scale. Stakeholders proposed 165 total solutions to the identified problems. CB-TVT is a promising educational model for anesthesiology residency, which potentially results in learner flexibility, individualization of curricula, and utilization of competencies to determine learner advancement. Because of the potential problems with the implementation of CB-TVT, it is important for future pilot implementations of CB-TVT to document realized problems, efficacy of solutions, and effects on educational outcomes to justify the burden of implementing CB-TVT.

P.117 Quantitative evaluation in competency-based medical education – a nationwide survey of the spinal surgical training landscape

Background: The competency-based medical education (CBME) model has been recently implemented in spinal neurosurgical and orthopedic residencies. This model is grounded on entrustable professional activities (EPAs) that allow the assessment of clinical milestones. Integrating quantitative metrics to evaluate procedural competencies could refine the assessment’s scope. This survey, administered to program directors (PDs), aims to evaluate the current state and anticipated needs for quantitative evaluation to develop innovative assessment techniques. Methods: We surveyed 32 PDs of neurosurgical (N=14) and orthopedics (N=16) programs with a spine service via RedCap. We collected information on the programs’ characteristics. We inquired about existing assessment methods and the perceived values of developing quantitative metrics to assess spinal technical competencies using thirteen questions. Results: The response rate was 53%. All programs use EPAs to assess procedural competencies through direct observation in the operation room. One surgical program employed quantitative metrics for examination. Four PD valued the profitability of quantitative evaluation methods in a clinical or simulatory context. Conclusions: The use of quantitative metrics to assess spinal surgical competencies in Canadian neurosurgical and orthopedic residency programs is seldom. Despite its underutilization, PDs acknowledge the potential for quantitation to improve the accuracy and reliability of CBME assessments in both simulated and clinical settings.

Which Entrustment-Supervision Scale is Right for Pharmacy Education?

Entrustable professional activities (EPAs) are an outgrowth of the competency-based educational model to support workplace-based learner assessments and evaluation. A learner’s performance of EPAs is assessed by the degree of provided entrustment and required supervision rather than by a score, percentage, or letter grade typically assigned in traditional academic coursework. Entrustment-supervision (ES) scales are used to document learner progression and steer learner development over time. The purpose of this article is to critique various ES tools in health professions education for utilization within an EPA framework for learner assessment in workplace-based settings and to determine which will best suit pharmacy education. Exploring the advantages and disadvantages across all types of ES scales is a critical step in determining the most useful ES tool for use within a specific pharmacy institution and across the Academy. An ES scale with the traditional 5 levels, a prospective assessment frame, and increased stratification at lower levels should be recommended by the Academy and utilized in workplace-based settings for formative and summative assessment to provide more valid assessment of learners, support the ideal of life-long learning, and give more meaning for pharmacy faculty and learners within assessment.

A117 VALIDITY EVIDENCE FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY COMPETENCY ASSESSMENT TOOLS: A SYSTEMATIC REVIEW

Abstract Background Assessment of competence in endoscopic retrograde cholangiopancreatography (ERCP) is essential to ensure trainees possess the skills needed for independent practice. Traditionally, ERCP training has used the apprenticeship model, whereby novices learn skills under the supervision of an expert. A growing focus on procedural quality, however, has supported the implementation of competency-based medical education models which require documentation of a trainee’s competence for independent practice. Observational assessment tools with strong evidence of validity are critical to this process. Validity evidence supporting ERCP observational assessment tools has not been systematically evaluated. Purpose To conduct a systematic review of ERCP assessment tools and identify tools with strong evidence of validity using a unified validity evidence framework Method We conducted a systematic search using electronic databases and hand-searching from inception until August 2021 for studies evaluating observational assessment tools of ERCP performance. We used a unified validity framework to characterize validity evidence from five sources: content, response process, internal structure, relations to other variables, and consequences. Each domain was assigned a score of 0-3 (maximum score 15). We assessed educational utility and methodological quality using the Accreditation Council for Graduate Medical Education framework and the Medical Education Research Quality Instrument, respectively. Result(s) From 2769 records, we included 17 studies evaluating 7 assessment tools. Five tools were studied for clinical ERCP, one on simulated ERCP, and one on simulated and clinical ERCP. Validity evidence scores ranged from 2-12. The Bethesda ERCP Skills Assessment Tool (BESAT), ERCP Direct Observation of Procedural Skills Tool (ERCP DOPS), and The Endoscopic Ultrasound (EUS) and ERCP Skills Assessment Tool (TEESAT) had the strongest validity evidence with scores of 10, 12, and 11, respectively. Regarding educational utility, most tools were easy to use and interpret, and required minimal additional resources. Overall methodological quality was strong, with scores ranging from 10-12.5 (maximum 13.5). Conclusion(s) The BESAT, ERCP DOPS, and TEESAT have strong validity evidence compared to other assessments. Integrating tools into training may help drive learners’ development and support competency decision-making. Please acknowledge all funding agencies by checking the applicable boxes below CAG Disclosure of Interest None Declared

24. The Duke Microsurgery Training Model: Curriculum Creation and Implementation

Background: Given the increased emphasis on patient safety within healthcare systems, the ACGME now supports the use of competency-based education models. In surgery, the Fundamentals of Laparoscopic Surgery and Endoscopic Surgery were created to ensure a basic level of competency among graduating general surgery residents. In plastic surgery, despite the highly technical nature of the field, there are no comparable national programs. Regarding microsurgery, currently only 16% of programs require a skills assessment prior to participation in microsurgery in the operating room. Furthermore, 77% of residents think that a comprehensive, multi-year training curriculum would be beneficial. Therefore, our goal was to create a comprehensive, multi-year curriculum for Duke Plastic Surgery residents to develop microsurgery skills. Methods: The Duke Microsurgery Training Model was created by evaluating currently published curricula for microsurgery training including currently available skills simulations and assessment rubrics. They were then adapted into a proposed multi-year microsurgery curriculum for a 6-year integrated residency program to support the development of microsurgery skills. Results: We developed a 6-year microsurgery curriculum that will be implemented over the course of this year. Based on the curriculum, each class has one dedicated teaching session in the microsurgery lab to work on a pre-defined set of level appropriate skills. Additionally, the PGY 1/2 classes will have a dedicated introduction to microsurgery including the standard instruments and use and the microscope use. The curriculum will be evaluated using standardized survey data and will be iteratively improved based on resident feedback. Further, each resident will be video recorded performing an end-to-end anastomosis at the end of each year. These will be reviewed and graded in a blinded manner using the Stanford Microsurgery and Resident Training Scale (SMaRT). The grades will be released to the residents yearly as part of their comprehensive feedback. Conclusion: Creation and implementation of the Duke Microsurgery Training Model will allow Duke to create a standardized and competency-based training model for the highly technical skill of microsurgical anastomosis. Using this model, we hope to have the junior residents become proficient in microsurgical skills before performing these skills intraoperatively.

Knowledge and Perceptions of Competency-Based Medical Education in Diagnostic Radiology Post-Graduate Medical Education: Identifying Priorities and Developing a Framework for Professional Development Activities.

Introduction: We evaluated knowledge and perceptions of an established Competency-Based Medical Education (CBME) model developed by the Royal College of Physicians and Surgeons of Canada, Competence by Design (CBD), and identified evidence-informed priorities for professional development activities (PDAs). Materials and Methods: Teaching faculty and residents at a single, large diagnostic radiology post-graduate medical education (PGME) program were eligible to participate in this cross-sectional, survey-based study. Knowledge of CBD was evaluated through multiple choice questions (MCQs), which assessed participants' understanding of major principles and terms associated with CBD. Participants' perceptions of the anticipated impact of CBD on resident education and patient care were evaluated and priorities for PDAs were identified, which informed a framework for CBD PDAs. Results: Fifty faculty and residents participated. The faculty and resident response rates were 11.6% (n = 29/249) and 55.3% (n = 21/38), respectively. The mean ± standard deviation overall score on MCQs was 39.0% ± 20.4%. The majority of participants perceived the impact of CBD on resident education to be equivocal and to not impact patient care. Knowledge of CBD was not statistically significantly associated with participants' perceptions of the impact of CBD on either resident education or patient care (P > .05). Delivery of high-quality feedback was the greatest priority identified for PDAs. Discussion: Our results and proposed CBD PDAs framework may help to guide diagnostic radiology PGME programs in designing evidence-informed PDAs, which may meaningfully contribute to the successful implementation of CBD in diagnostic radiology PGME. As diagnostic radiology PGME programs throughout the world increasingly implement CBME models, evidence-informed PDAs will become of increasing importance.

Longitudinal assessment of competency development at The Ohio State University using the competency-based veterinary education (CBVE) model.

With the development of the American Association of Veterinary Medical Colleges' Competency-Based Veterinary Education (CBVE) model, veterinary schools are reorganizing curricula and assessment guidelines, especially within the clinical rotation training elements. Specifically, programs are utilizing both competencies and entrustable professional activities (EPAs) as opportunities for gathering information about student development within and across clinical rotations. However, what evidence exists that use of the central tenets of the CBVE model (competency framework, milestones and EPAs) improves our assessment practices and captures reliable and valid data to track competency development of students as they progress through their clinical year? Here, we report on validity evidence to support the use of scores from in-training evaluation report forms (ITERs) and workplace-based assessments of EPAs to evaluate competency progression within and across domains described in the CBVE, during the final year clinical training period of The Ohio State University's College of Veterinary Medicine (OSU-CVM) program. The ITER, used at the conclusion of each rotation, was modified to include the CBVE competencies that were assessed by identifying the stage of student development on a series of descriptive milestones (from pre-novice to competent). Workplace based assessments containing entrustment scales were used to assess EPAs from the CBVE model within each clinical rotation. Competency progression and entrustment scores were evaluated on each of the 31 rotations offered and high-stakes decisions regarding student performance were determined by a collective review of all the ITERs and EPAs recorded for each learner across each semester and the entire year. Results from the class of 2021, collected on approximately 190 students from 31 rotations, are reported with more than 55 299 total competency assessments combined with milestone placement and 2799 complete EPAs. Approximately 10% of the class was identified for remediation and received additional coaching support. Data collected longitudinally through the ITER on milestones provides initial validity evidence to support using the scores in higher stakes contexts such as identifying students for remediation and for determining whether students have met the necessary requirements to successfully complete the program. Data collected on entrustment scores did not, however, support such decision making. Implications are discussed.

Public Health Workforce training Laboratorium: Pilot e-Learning course on CBE and PBL models

Abstract Background The National Institute of health (ISS), within the G20 Health Working Group, launched at March 2021 an innovative training Laboratorium, to strengthen the capacity and competencies of the Public Health Workforce (PHW) on prevention, preparedness and response to health crises. It was recognised in the G20 Declarations of Ministers of Health and Leaders and it was aimed to the development of training tools suitable for distance learning. ISS proposed the design of e-Learning courses based on an integration of WHO’s Competency-Based Education (CBE) and Problem Based Learning (PBL) models. Objectives Describe the design of a pilot e-Learning course based on CBE- PBL models, focused on Epidemic Intelligence (EI). Results The pilot e-Learning course “Use of Epidemic Intelligence systems with a particular focus on event-based surveillance for pandemic preparedness” will be delivered by ISS e-Learning platform https://www.eduiss.it. By the end of the course participants will be able to evaluate the potential use/applicability of EI systems, focusing on event-based surveillance for preparedness and early warning at country/institutional level. CBE is the basis for articulating the outcomes and identifying the required competencies and PBL for creating learning activities associated to learning outcomes. Interactive tools (exercise, web pages, quiz and other activities) are associated to learning objectives. The course is offered to public health professionals free of charge, in English language. About 16 hours are required to complete all the activities and receive attendance certification. Conclusions Continuously updated training of PHW is a hallmark to better face health challenges. In our proposal, the learning methodology integrates CBE vision with PBL approach, adapting both to e-Learning context. Aknowledement Pietro Carbone, Debora Guerrera, Federica Regini, Licia Bacciocchi, Stefania Bocci, Silvia Stacchini, Giovanna Failla - ISS, Rome Italy Key messages • Design an innovative e-learning course through synergic integration of two educational models crucial in public health, CBE and PBL. • Adapt e valorize CBE and PBL models in the context of e-Learning.

Applying Nurse Practitioner Student Reflections in Design of Telehealth Curricula

Telehealth demand increased precipitously among all populations, particularly Medicare beneficiaries with complex care needs, during the coronavirus disease 2019 pandemic. Current nurse practitioner (NP) graduates require practice readiness in telehealth when transitioning to advanced practice. Competency-based education models integrate progressive, multimodal evaluation of core practice competencies, including telehealth. Self-reflection supports student acquisition of new competencies. Thematic analysis of guided reflections after a pilot gerontologic robot-enabled telehealth simulation identified curricular opportunities in a primary care NP program. NP students’ perceived challenges in communication and adaptation to virtual patient presence were considered in building integrated telehealth curricula in clinical courses applying the 4Ps of Telehealth Education (Planning, Preparing; Providing; and Performance Improvement) framework.

Implementation of entrustable professional activities into fellowship council accredited programs: a pilot project.

ObjectiveThe Fellowship Council (FC) is transitioning to a competency-based medical education (CBME) model, including the introduction of Entrustable Professional Activities (EPAs) for training and assessment of Fellows. This study describes the implementation process employed by the FC during a ten-month pilot project and presents data regarding feasibility and perceived value.MethodsThe FC coordinated the development of EPAs in collaboration with the sponsoring societies for Advanced GI/MIS, Bariatrics, Foregut, Endoscopy and Hepatopancreaticobiliary (HPB) fellowships encompassing the preoperative, intraoperative, and postoperative phases of care for key competencies. Fifteen accredited fellowship programs participated in this project. The assessments were collected through a unique platform on the FC website. Programs were asked to convene a Clinical Competency Committee (CCC) on a quarterly basis. The pilot group met monthly to support and improve the process. An exit survey evaluated the perceived value of EPAs.ResultsThe 15 participating programs included 18 fellows and 106 faculty. A total of 655 assessments were initiated with 429 (65%) completed. The average (SD) number of EPAs completed for each fellow was 24(18); range 0–72. Intraoperative EPAs were preferentially completed (71%). The average(SD) time for both the fellow and faculty to complete an EPA was 27(78) hours. Engagement increased from 39% of fellows completing at least one EPA in September to 72% in December and declining to 50% in May. Entrustment level increased from 6% of EPAs evaluated as “Practice Ready” in September to 75% in June. The exit survey was returned by 63% of faculty and 72% of fellows. Overall, 46% of fellows and 74% of program directors recommended full-scale implementation of the EPA framework.ConclusionA competency-based assessment framework was developed by the FC and piloted in several programs. Participation was variable and required ongoing strategies to address barriers. The pilot project has prepared the FC to introduce CBME across all FC training programs.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00464-022-09502-5.