Feasibility, and validity aspects of Entrustable Professional Activity (EPA)-based assessment in general practice training

Abstract

Introduction: Entrustable Professional Activities (EPAs) are developed to support the practicalapplication of competency frameworks in postgraduate medical education (PGME) programmes.EPAs are used for the assessment of the trainees’ competence development, which takes place bymeans of an entrustment decision, aiming to stimulate learning and independent practice intrainees. In this pilot study, we explore the feasibility and validity of EPA-based assessment ina General Practice (GP) training programme.Methods: We used questionnaires to evaluate trainers’ and trainees’ experiences with the use ofsix EPAs for trainee learning, assessment and independent practice at the Out-of-Hours GP Center.Data were analysed quantitatively and qualitatively. Additionally, we examined the inter-itemcorrelation between scores on EPA-based assessment and competency-based assessment usingSpearman’s Rho.Results: EPA-based assessment provided opportunities for giving concrete feedback and sub-stantiating competency-based assessment. No consistent correlation between EPA-based assess-ment and competency-based assessment could be detected. Only later in the course of thetraining programme a correlation was found between the EPA scores and the degree of indepen-dence of trainees.Discussion: Results of this pilot study confirm the theories behind EPAs, as well as earlier researchon EPAs in the workplace regarding trainee learning, assessment and independent practice. Animportant limitation of this study was the COVID-19 pandemic, as it influenced the results throughreduced inclusion and follow-up, and through the impact on the workplace and trainee learningpossibilities. Further research is needed to determine how EPAs support independent practice oftrainees, as well as the assessment of trainee competency development.