title: Developing entrustable professional activities as the basis for assessment of competence in an internal medicine residency: a feasibility study.
abstract: BACKGROUND
  Graduate medical education programs assess trainees' performance to determine readiness for unsupervised practice. Entrustable professional activities (EPAs) are a novel approach for assessing performance of core professional tasks.
  
  
  OBJECTIVE
  To describe a pilot and feasibility evaluation of two EPAs for competency-based assessment in internal medicine (IM) residency.
  
  
  METHODS
  Post-graduate year-1 interns (PGY-1s) and attendings at a large internal medicine (IM) residency program.
  
  
  METHODS
  Two Entrustable professional activities (EPA) assessments (Discharge, Family Meeting) were piloted.
  Twenty-eight out of 43 (65.1 %) PGY-1 s and 32/43 (74.4 %) attendings completed surveys about the Discharge EPA experience. Most who completed the EPA assessment (10/12, 83.8 %, PGY-1s; 9/11, 83.3 %, attendings) agreed it facilitated useful feedback discussions. For the Family Meeting EPA, 16/26 (61.5 %) PGY-1s completed surveys, and most who participated (9/12 PGY1s, 75 %) reported it improved attention to family meeting education, although only half recommended continuing the EPA assessment.
  
  
  CONCLUSIONS
  From piloting two EPA assessments in a large IM residency, we recognized our reminder systems and time dedicated for completing EPA requirements as inadequate. Collaboration around patient safety and palliative care with relevant clinical services has enhanced implementation and buy-in. We will evaluate how well EPA-based assessment serves the intended purpose of capturing trainees' trustworthiness to conduct activities unsupervised.
authors.affiliation: Department of Medicine, University of California, San Francisco, USA. Karen.hauer@ucsf.edu
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hauer
authors.forename: Krishan
authors.initials: K
authors.lastname: Soni
authors.forename: Patricia
authors.initials: P
authors.lastname: Cornett
authors.forename: Jeff
authors.initials: J
authors.lastname: Kohlwes
authors.forename: Harry
authors.initials: H
authors.lastname: Hollander
authors.forename: Sumant R
authors.initials: SR
authors.lastname: Ranji
authors.forename: Olle
authors.initials: O
authors.lastname: Ten Cate
authors.forename: Eric
authors.initials: E
authors.lastname: Widera
authors.forename: Brook
authors.initials: B
authors.lastname: Calton
authors.forename: Patricia S
authors.initials: PS
authors.lastname: O'Sullivan
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003133:Commission on Professional and Hospital Activities / Q000592:standards*; D005240:Feasibility Studies; D006801:Humans; D007388:Internal Medicine / Q000379:methods / Q000592:standards*; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D010865:Pilot Projects; D014481:United States