Faculty and Resident Perspectives on the Implementation of Entrustable Professional Activities in General Surgery Residency

Rebecca Lynn Williams-Karnesky; Erin White; Amy Holmstrom; Nicole Garcia; Jason Johnson; Mackenzie Cook; Brianne Nickel; George Sarosi; Jo Buyske; John Mellinger; Jacob A Greenberg

doi:10.1016/j.jsurg.2024.03.006

Faculty and Resident Perspectives on the Implementation of Entrustable Professional Activities in General Surgery Residency

J Surg Educ. 2024 Apr 24:S1931-7204(24)00152-1. doi: 10.1016/j.jsurg.2024.03.006. Online ahead of print.

Authors

Affiliations

¹ Northwestern University, Chicago, Illinois.
² Yale University Department of Surgery, New Haven, Connecticut.
³ Indiana University School of Medicine, Indianapolis, Indiana.
⁴ East Carolina University Department of Surgery, Greenville, North Carolina.
⁵ Intermountain Health, Denver, Colorado.
⁶ Oregon Health and Sciences University, Portland, Oregon.
⁷ University of Florida Department of Surgery, Gainesville, Florida.
⁸ American Board of Surgery, Philadelphia, Pennslyvania.
⁹ Duke University Department of Surgery, Durham, North Carolina. Electronic address: Jacob.greenberg@duke.edu.

PMID: 38664173
DOI: 10.1016/j.jsurg.2024.03.006

Abstract

Objective: This study aimed to identify what best practices facilitate implementation of Entrustable Professional Activities (EPAs) into surgical training programs.

Design: This is a mixed methods study utilizing both survey data as well as semi-structured interviews of faculty and residents involved in the American Board of Surgery (ABS) EPA pilot study.

Setting: From 2018 to 2020, the ABS conducted a pilot that introduced five EPAs across 28 general surgery training programs.

Participants: All faculty members and residents at the 28 pilot programs were invited to participate in the study.

Results: About 117 faculty members and 79 residents responded to the survey. The majority of faculty (81%) and residents (66%) felt that EPAs were useful and were a valuable addition to training. While neither group felt that EPAs were overly time consuming to complete, residents did report difficulty incorporating them into their daily workflow (44%). 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.

Conclusions: EPA implementation is feasible in general surgery training programs but requires significant effort and engagement from all levels of program personnel. As EPAs are implemented by the ABS nationally a focus on resident and faculty development will be critical to success.

Keywords: competency based medical education; entrustable professional activities; residency training; surgery education.