Journal Article10.1097/xcs.0000000000000168
Concurrent Validity Evidence for Entrustable Professional Activities in General Surgery Residents
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TL;DR: In this paper , a subset of Entrustable Professional Activities (EPAs) has been developed for general surgery residents to evaluate their competency, including concurrent validity compared to ACGME milestones, the current gold standard for evaluating competency.
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Abstract: In Brief Export BACKGROUND: A subset of Entrustable Professional Activities (EPAs) has been developed for general surgery. We aim to contribute validity evidence for EPAs as an assessment framework for general surgery residents, including concurrent validity compared to ACGME milestones, the current gold standard for evaluating competency. STUDY DESIGN: This is a cross-sectional study in a general surgery training program within a tertiary academic medical center. EPA assessments were submitted using a mobile app and scored on a numerical scale, mirroring milestones. EPA score distribution was analyzed with respect to post-graduate year (PGY) level and phase of care. Proportional odds logistic regression identified significant predictors. Spearman rank and Wilcoxon rank tests were used for comparisons with milestone ratings. RESULTS: From August 2018 to December 2019, 320 assessments were collected. EPA scores increased by PGY level. Operative phase EPA scores were significantly lower than nonoperative phase scores. PGY level, operative phase, and case difficulty significantly influenced entrustment scoring. EPA scores demonstrated strong correlation with nonoperative milestones patient care-1, medical knowledge-1, interpersonal and communication skills-2, interpersonal and communication skills-3, professionalism-1, professionalism-3, and practice-based learning and improvement-2 (ρ > 0.5, p < 0.05) and a weaker correlation with operative milestones patient care-3 and medical knowledge-2 (ρ < 0.5, p < 0.05). CONCLUSIONS: The influence of PGY level and operative phase on entrustment scoring supports the validity of EPAs as a formative evaluation framework for general surgery resident performance. In addition, evident correlations between EPA scores and respective milestone ratings provide concurrent validity evidence. Entrustable professional activities are a reliable evaluation framework for general surgery resident performance, demonstrated in our study by the influence of PGY level and operative phase on entrustment scoring and by the evident correlation between entrustable professional activities scores and respective ACGME milestone ratings.
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Citations
Disparities in the Operative Experience Between Female and Male General Surgery Residents
Alexander R. Cortez,Maryke Van Zyl,Javier Reyes,Mark,Katie Johnson,Amy Gass,d8clxsa240,Azam Khan +7 more
TL;DR: In this paper , the authors examined differences in resident operative experience between male and female general surgery residents and found that female graduates were less likely to be high-volume residents (27% vs. 36%, P<0.01).
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Entrustable Professional Activities in Surgery: A Review.
Kelsey B. Montgomery,John D. Mellinger,Brenessa Lindeman +2 more
TL;DR: EPA implementation in general surgery provides a competency-based assessment framework for residents, offering a more accurate picture of competence compared to other assessment methods. Challenges include gaining faculty and resident buy-in and integrating EPAs into program workflows.
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Validity of Entrustable Professional Activities in a National Sample of General Surgery Residency Programs.
Kelsey B. Montgomery,John D. Mellinger,Andrew Jones,M. C. McLeod,Polina Zmijewski,George A. Sarosi,Karen J Brasel,Mary E. Klingensmith,Rebecca M. Minter,Jo Buyske,Brenessa Lindeman +10 more
TL;DR: The validity of EPAs in general surgery is supported and EPA assessments can be utilized to inform Milestone ratings by CCCs, suggesting that EPA assessments can be utilized to inform Milestone ratings by CCCs.
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Roll the Tape: Implementing and Harnessing the Power of Trauma Video Review.
Ryan P. Dumas,Caitlin Cook,Daniel N. Holena,Yanjie Qi,Nora Tabone,Spencer L. Studwell,Aekta Miglani,Michael A. Vella +7 more
TL;DR: In this article , the authors describe the development of a TVR program and the novel way in which they have integrated TVR into their resident trauma curriculum, which is an ideal tool for general surgery trainee education and as a means to evaluate multiple ACGME Core Competencies and entrustable professional activities.
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Faculty and Resident Perspectives on the Implementation of Entrustable Professional Activities in General Surgery Residency.
Rebecca Lynn Williams-Karnesky,Erin M. White,Amy Holmstrom,Nicole Garcia,Jason Johnson,Mackenzie R Cook,Brianne Nickel,George Sarosi,Jo Buyske,John D. Mellinger,Jacob A Greenberg +10 more
TL;DR: Semi-structured interviews found that programs that focused on faculty and resident -development and utilized frequent reminders about the importance and necessity of EPAs tended to perform better.
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References
Nuts and Bolts of Entrustable Professional Activities
TL;DR: The entrustable professional activity (EPA) concept allows faculty to make competency-based decisions on the level of supervision required by trainees, addressing the concern that competency frameworks would otherwise be too theoretical to be useful for training and assessment in daily practice.
General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors.
Samer G. Mattar,Adnan Alseidi,Daniel B. Jones,D. Rohan Jeyarajah,Lee L. Swanstrom,Ralph W. Aye,Stephen D. Wexner,Jose M. Martinez,Sharona Ross,Michael M. Awad,Morris E. Franklin,Maurice E. Arregui,Bruce D. Schirmer,Rebecca M. Minter +13 more
TL;DR: Assessment of general surgery graduate trainees entering accredited surgical subspecialty fellowships in North America revealed deficits in domains of operative autonomy, progressive responsibility, longitudinal follow-up, and scholarly focus after general surgery education.
758
Implementation of competency-based medical education: are we addressing the concerns and challenges?
Richard E. Hawkins,Catherine M. Welcher,Eric S. Holmboe,Lynne M. Kirk,John J. Norcini,Kenneth B. Simons,Susan E. Skochelak +6 more
TL;DR: Competency‐based medical education has emerged as a core strategy to educate and assess the next generation of physicians with a focus on outcomes and learner achievement.
361
Attitudes, training experiences, and professional expectations of US general surgery residents: a national survey.
Heather L. Yeo,Kate V. Viola,David N. Berg,Zhenqiu Lin,Marcella Nunez-Smith,Cortland Cammann,Richard H. Bell,Julie Ann Sosa,Harlan M. Krumholz,Leslie A. Curry +9 more
TL;DR: General surgery residents' attitudes, experiences, and expectations regarding training reflect both high levels of satisfaction and sources of strain, which vary by sex and training year.
301
Competency-based Residency Training: The Next Advance in Graduate Medical Education
TL;DR: The author proposes the replacement of the current approach to residents' education, which specifies a fixed number of years in training, with competency-based training, in which each resident remains in training until he or she has been shown to have the required knowledge and skills and can apply them independently.
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