Program Directors Weigh In On 13 Core Entrustable Professional Activities (EPAs) 

Entrustable Professional Activities: Thirteen core EPAs have been proposed as a standard for North American medical school graduation.  In this study, researchers surveyed internal medicine program directors (PDs) for their views on the EPAs: their importance, observed performance gaps in their own trainees, and methods of communication across training settings.  The survey response rate was 57%, with a modest over-representation of larger and university-based programs.  At least 75% of these PDs thought that their entering interns “must” or “should” be able to perform without direct supervision 11 of the 13 proposed EPAs.  The two activities not meeting this bar were “Identify systems failures and contribute to a culture of safety and improvement” and “Perform general procedures of a physician”. {Editor’s note: surgical PDs might well rank this last EPA higher.}  Major gaps were noted between entering interns’ actual capabilities under indirect supervision and our expectations, even in EPAs rated among the most important, including developing a prioritized differential diagnosis, providing oral presentations, and recognition of patients requiring urgent or emergent care.  Majorities of PDs agreed that EPA information should be shared by medical schools with residency programs, and then by residency programs  with fellowship programs and employers; and 71% felt that an EPA checklist from medical schools would be helpful.  There was less consensus on the timing and optimal use of such information. — Laura Willett, MD

Angus, Steven V. MD; Vu, T. Robert MD; Willett, Lisa L MD, MACM; Call, Stephanie MD, MSPH; Halvorsen, Andrew J. MS; Chaudhry, Saima MD, MSHS “Internal Medicine Residency Program Directors’ Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum.” Academic Medicine, Oct 2016

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