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Entrustable professional activities for workplace assessment of general practice trainees
Author(s) -
Valentine Nyoli,
Wignes Jon,
Benson Jill,
Clota Stephanie,
Schuwirth Lambert WT
Publication year - 2019
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.50130
Subject(s) - psychology , medical education , applied psychology , medicine
Objective To assess whether entrustment levels for junior trainees with respect to entrustable professional activities ( EPA s) increase over time; whether entrustment levels for senior trainees are higher than for junior trainees; and whether self‐assessment of entrustment levels by senior trainees more closely matches supervisor assessment than self‐assessment by junior trainees. Design, setting, participants Observational study of 130 junior and 153 senior community‐based general practice trainees in South Australia, 2017. Main outcome measures Differences in entrustment levels between junior and senior trainees; change in entrustment levels for junior trainees over 9 months; concordance of supervisor and trainee assessment of entrustment level over 9 months. Results Senior trainees were 2.1 (95% CI , 1.66–2.58) to 3.7 times (95% CI , 2.60–5.28) as likely as junior trainees to be entrusted with performing clinical EPA s without supervision. The proportion of EPA s with which junior trainees were entrusted to perform unsupervised increased from 26% at 3 months to 35% at 6 months (rate ratio [ RR ], 1.37; 95% CI ; 1.15–1.63), to 50% at 9 months ( RR , 1.92; 95% CI , 1.64–2.26), and 69% at 12 months ( RR , 2.68; 95% CI ; 2.32–3.12). At 3 months, the mean differences in entrustment ratings between supervisors and trainees was 5.5 points ( SD , 6.6 points) for junior trainees and 2.93 points ( SD , 2.8 points) for senior trainees ( P < 0.001). Conclusions EPA s are valid assessment tools in a workplace‐based training environment.