Using EPA’s For Competency-Based Assessment Of Medical Students In The Internal Medicine (IM) Clerkship

Assessment: Alliance for Academic Internal Medicine Undergraduate Medical Education (UME) Task Force proposes a model for competency-based assessment in IM clerkships, informed by results of a survey of clerkship directors who were asked to identify high priority EPA’s (entrustable professional activities) for students in the IM clerkship. Six EPA’s were identified as important for assessment in the IM clerkship and were related to accuracy in obtaining a history and physical, importance of verbal and written communication, interpretation of diagnostic studies, and generating differential diagnoses. Subdivisions under these EPA’s were also suggested, with use of an entrustment/supervision scale anchored by “not allowed to practice,” “allowed under full supervision,” and “allowed with on-demand supervision.”

What the authors propose is a potentially useful model for competency-based assessment in the IM clerkship that would also align UME assessment with how GME assessment is currently being done. However, their proposal is not quite ready for use in the current educational environment. A formidable challenge to implementation of such an assessment is the larger paradigm shift that would need to take place to replace clerkship grades with a dichotomous scale of meets standards or does not meet standards. How likely that is to happen in the next few years is hard to say but this is a topic that is being actively debated in the educational community. So stay tuned…
–Sarang Kim, MD

Fazio SB, Ledford CH, Aronowitz PB, Chheda SG, Choe JH, Call SA, Gitlin SD, Muntz M, Nixon LJ, Pereira AG, Ragsdale JW, Stewart EA, Hauer KE. Competency-Based Medical Education in the Internal Medicine Clerkship: A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force. Acad Med. 2017 Sep

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