Entrustable Professional Activities (EPAs) at WVSOM: Fast Facts

July 2019

With EPA assessment, the focus is on providing information to learners, docu-menting direct or indirect observation on a regular basis (in a way that is practical for the reality for you and your work team), and short focused feedback to coach them in using this information to continue to advance their skills.

You will complete brief records (through the EPA app) of the observed tasks (EPAs). The observations you make will be reviewed regularly (along with other reports) by WVSOM. WVSOM will monitor whether students can be “entrusted” with the EPA, progression through training, and gaps that may need to be addressed related to progression. This is meant to be FORMATIVE.

This new assessment aims to:

Identify emerging abilities/competencies of individual learners at different stages of training and in different contexts

Provide guidance to address identified gaps in progression

Employ assessment that is better aligned with clinical practice

Entrustable: acts that require trust – by colleagues, patients, public

Professional: confined to occupations with extra-ordinary qualification and right

Activities: tasks that must be done EPAs ground competencies in daily practice

One can possess competencies, not EPAs (tasks), EPAs include several competencies

For more information, contact Dr. Machelle Linsenmeyer at 304-793-2871 or alinsenmeyer@osteo.wvsom.edu.

ten Cate et al., 2010 ten Cate et al., 2015

Additional Readings

ten Cate, O. et al. 2010, Medical competence: The interplay between individual ability and the health care environment. Medical Teacher, 32:669-675.

ten Cate, O. et al., 2015. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99. Medical Teacher, 37(12): 983–1002.

ten Cate, O. et al., 2016. Entrustment decision-making in clinical training. Academic Medicine, 91(2):191–198. ten Cate, O. et al., 2018. The EPA-based Utrecht undergraduate clinical curriculum: Development and implementation. Medical Teacher, 40(5):506-513.

Chen, HC. et al. 2015. The case for use of entrustable professional activities in undergraduate medical education. Academic Medicine, 90(4):431-436. Peters, H. et al., 2017. Twelve tips for the implementation of EPAs for assessment and entrustment decisions. Medical Teacher, 39:802-807. Hauer, K.E. et al., 2014. Understanding trust as an essential element of trainee supervision and learning in the workplace. Advances in Health Sciences Education, 19(3):435–56. Kennedy, T.J.T. et al., 2008. Point-of-Care Assessment of Medical Trainee Competence for Independent Clinical Work. Academic Medicine. 83(10):S89-S92.

Sargeant, J. et al., 2016. Evidence-informed facilitated feedback: the R2C2 feedback model. MedEdPORTAL. 12:10387

AACOM EPA Document: https://www.aacom.org/docs/default-source/med-ed-presentations/core-epas.pdf?sfvrsn=10

AAMC EPA Document: https://members.aamc.org/eweb/upload/core%20EPA%20Curriculum%20Dev%20Guide.pdf

Mayer RC, et al. 1995. An Integrative Model of Organizational Trust. Acad Manage J. 20:709–34.

Level of Supervision Scale

Allowed to observe

As a co-activity with supervisor

With supervisor in the room ready to step in With supervisor immediately available, all findings/decisions double checked With supervisor immediately available, all findings/decisions double checked

With supervisor distantly available, find-ings/decisions reviewed

With supervisor available on call to come provide supervision

With supervisor no available but may provide feedback and monitoring in hindsight Chen et al., 2015; Harm et al, 2017; ten Cate et al, 2018 Dash line is the anticipated threshold for UME

Elements of Trustworthiness

Ability– Competency, skill, knowledge Integrity– Honesty/truthfulness, benevolence Reliability– Conscientious and consistent behavior Humility– Observing limits and willing to ask help Kennedy et al., 2008; Hauer et al., 2014; ten-Cate et al., 2016; Mayer, 1995

Opportunities for Feedback

There are various times in the EPA app to provide critical feedback to the stu-dent.

You can type or click the microphone button on the keyboard and verbally dictate your response.

Discuss with the student as you are entering the information. Ask questions to explore their understanding and guide the learner in developing a plan for change. Sargeant J et al.

Final Signature Screen

You can use your finger or a stylus to enter your signature. This step is important because it proves that you completed the assessment. NOTE: You can verify the assessments you have signed off on in a preceptor log that will be available in eMedley .

Make sure to click the Finish button to upload the assessment.

AAMC, 2014; AACOM, 2016