• Karen E Hauer, Krishan Soni, Patricia Cornett, Jeff Kohlwes, Harry Hollander, Sumant R Ranji, Olle Ten Cate, Eric Widera, Brook Calton, and Patricia S O'Sullivan.
• Department of Medicine, University of California, San Francisco, USA. Karen.hauer@ucsf.edu
• J Gen Intern Med. 2013 Aug 1; 28 (8): 1110-4.

BackgroundGraduate 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.AimTo describe a pilot and feasibility evaluation of two EPAs for competency-based assessment in internal medicine (IM) residency.Setting/ParticipantsPost-graduate year-1 interns (PGY-1s) and attendings at a large internal medicine (IM) residency program.Program DescriptionTwo Entrustable professional activities (EPA) assessments (Discharge, Family Meeting) were piloted.Program Feasibility EvaluationTwenty-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.DiscussionFrom 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.

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