Setting standards of performance expected in neurosurgery residency: A study on entrustable professional activities in competency-based medical education

Am J Surg. 2020 Dec 8;S0002-9610(20)30792-3. doi: 10.1016/j.amjsurg.2020.12.014. Online ahead of print.


Background: Competency-based medical education requires evaluations of residents' performances of tasks of the discipline (ie. entrustable professional activities (EPAs)). Using neurosurgical Faculty perspectives, this study investigated whether a sample of neurosurgical EPAs accurately reflected the expectations of general neurosurgical practice.

Method: A questionnaire was sent to all Canadian neurosurgery Faculty using a SurveyMonkey® platform.

Results: The proportion of respondents who believed the EPAs were representative of general neurosurgery competences varied significantly across all EPAs [47%-100%] (p < 0.0001). For 9/15 proposed EPAs, ≥75% agreed they were appropriate for general neurosurgery training and expected residents to attain the highest standard of performance. However, a range of 27-53% of the respondents felt the other six EPAs would be more appropriate for fellowship training and thus, require a lower standard of performance from graduating residents.

Conclusion: The shift towards subspecialization in neurosurgery has implications for curriculum design, delivery and certification of graduating residents.

Keywords: Competence standards; Competency-based medical education; Entrustable professional activities; Neurosurgery.