Nyoli Valentine1, Jon Wignes1, Jill Benson1, Stephanie Clota1, Lambert Wt Schuwirth2,3. 1. ModMed Institute of Health Professions Education, Adelaide, SA. 2. Prideaux Centre for Research in Health Professions Education, Flinders University, Adelaide, SA. 3. Educational Development and Research, Maastricht University, Maastricht, The Netherlands.
Abstract
OBJECTIVE: To assess whether entrustment levels for junior trainees with respect to entrustable professional activities (EPAs) 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 EPAs without supervision. The proportion of EPAs 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: EPAs are valid assessment tools in a workplace-based training environment.
OBJECTIVE: To assess whether entrustment levels for junior trainees with respect to entrustable professional activities (EPAs) 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 EPAs without supervision. The proportion of EPAs 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:EPAs are valid assessment tools in a workplace-based training environment.
Authors: Adam Watson; Timothy Leroux; Darrell Ogilvie-Harris; Markku Nousiainen; Peter C Ferguson; Lucas Murnahan; Tim Dwyer Journal: JB JS Open Access Date: 2021-04-09