title: Entrustment and mapping of observable practice activities for resident assessment.
abstract: Entrustable Professional Activities (EPAs) and the Next Accreditation System reporting milestones reduce general competencies into smaller evaluable parts. However, some EPAs and reporting milestones may be too broad to use as direct assessment tools. We describe our internal medicine residency curriculum and assessment system, which uses entrustment and mapping of observable practice activities (OPAs) for resident assessment. We created discrete OPAs for each resident rotation and learning experience. In combination, these serve as curricular foundation and tools for assessment. OPA performance is measured via a 5-point entrustment scale, and mapped to milestones and EPAs. Entrustment ratings of OPAs provide an opportunity for immediate structured feedback of specific clinical skills, and mapping OPAs to milestones and EPAs can be used for longitudinal assessment, promotion decisions, and reporting. Direct assessment and demonstration of progressive entrustment of trainee skill over time are important goals for all training programs. Systems that use OPAs mapped to milestones and EPAs provide the opportunity for achieving both, but require validation.
authors.affiliation: University of Cincinnati Academic Health Center, 231 Albert Sabin Way ML 0557, Cincinnati, OH, 45267-0557, USA, warmej@ucmail.uc.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Warm
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Mathis
authors.forename: Justin D
authors.initials: JD
authors.lastname: Held
authors.forename: Savita
authors.initials: S
authors.lastname: Pai
authors.forename: Jonathan
authors.initials: J
authors.lastname: Tolentino
authors.forename: Lauren
authors.initials: L
authors.lastname: Ashbrook
authors.forename: Cheryl K
authors.initials: CK
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: Sharice
authors.initials: S
authors.lastname: Wood
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Fichtenbaum
authors.forename: Daniel
authors.initials: D
authors.lastname: Schauer
authors.forename: Ryan
authors.initials: R
authors.lastname: Munyon
authors.forename: Caroline
authors.initials: C
authors.lastname: Mueller
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D015397:Program Evaluation / Q000379:methods / Q000592:standards*