Bethany Auble
Children's Hospital of Wisconsin
Background: Entrustable Professional Activities (EPAs) are tangible competencies of medical education and are quickly becoming a focus for evaluating medical students. Direct observation by supervising physicians of these skills is a key component of entrusting students to practice independently. A valid and reliable tool for evaluating EPAs does not currently exist in medical education.
Aim: To create a tool for a single EPA for a pilot study using direct observation of a medical student performing a History and Physical Exam that is valid and reliable.
Methods: Residents directly observed a medical student performing a H&P and used a EPA tool to assess performance. A subset of students was also directly observed by faculty member for comparison by intra-class correlation. A survey was completed by the residents after using the EPA tool.
Results: Intra-class correlation was predictive of a similar observation from residents and faculty experience, correlation coefficient 0.671- 0.923. Inter-item reliability was measured by Cronbach’s alpha of 0.924. The survey revealed the residents’ lack of knowledge of EPAs (median 2.0, SD 0.5), and they found that the tool was useful and would like to use it in the future (median 4.0, SD 0.5).
Conclusion: This pilot study revealed that the EPA tool was a valid and reliable tool for directly observing medical students during H&P and provides strong intra-class correlation for agreement between senior resident and faculty observations.
