Entrustable professional activity-based assessments in undergraduate medical education: A Survey of Pediatric Educators

Acad Pediatr. 2021 Apr 7;S1876-2859(21)00213-8. doi: 10.1016/j.acap.2021.03.020. Online ahead of print.


Objective: To explore the use of entrustable professional activities (EPAs) in undergraduate medical education (UME), characterization of EPAs by pediatric educators, and opportunities and challenges with an EPA framework.

Methods: In 2020, nine survey questions were administered to members of the Council on Medical Student Education in Pediatrics, a national pediatric UME group. Clark's Commitment and Necessary Effort model on motivation served as the theoretical framework for our study. Quantitative and qualitative data were analyzed using descriptive statistics and conventional content analysis, respectively.

Results: 167 (31%) of 479 recipients, representing 75% of accredited schools responded. 83% agreed that they understood what EPAs were, yet a minority reported using EPAs. 85% of EPA users expressed satisfaction with EPAs in providing a shared framework and an opportunity to track student competence; dissatisfaction was expressed towards faculty resource needs. Among non-users, barriers hindering implementation included faculty development challenges and faculty time. Qualitative analyses revealed a rich understanding of EPAs: that they offer a framework to measure learner competence by assessing performance in workplace-based tasks that can be used for entrustment decisions and for program evaluation.

Conclusions: Although most pediatric UME educators report understanding EPAs (contributing to self-efficacy) and recognize their benefits (value), a minority report actually using EPAs. EPAs, while providing a valuable framework, pose challenges from contextual factors affecting personal agency, which could affect educator commitment in implementation. For more widespread adoption of the EPAs, efforts should focus on minimizing these perceived barriers.

Keywords: EPA; Survey; Undergraduate medical education.