Motivations for Entrustable Professional Activity Assessment: Gaps Between Curriculum Theory and Resident Reality.

Publisher: Accreditation Council for Graduate Medical Education Country of Publication: United States NLM ID: 101521733 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1949-8357 (Electronic) Linking ISSN: 19498357 NLM ISO Abbreviation: J Grad Med Educ Subsets: MEDLINE

Original Publication: Chicago, ILL : Accreditation Council for Graduate Medical Education

Internship and Residency* ; Motivation* ; Curriculum* ; Competency-Based Education*/methods; Humans ; Canada ; Surveys and Questionnaires ; Clinical Competence ; Female ; Male ; Education, Medical, Graduate

Background Previous research demonstrates mixed reactions from residents toward competency-based medical education (CBME), and entrustable professional activities (EPAs) specifically. However, understanding what motivates residents to obtain EPAs may be vital to the longevity of CBME, given the emphasis on assessment for learning under this paradigm. Objective This study explored resident perspectives across 3 domains: motivation for obtaining EPAs, perceived importance of EPAs, and overall thoughts on CBME curriculum. Methods This was a sequential exploratory mixed-methods study involving 2 phases of data collection. Phase 1 was semi-structured interviews with residents enrolled in CBME at one Canadian institution from November 2019 to July 2020. Analyses included thematic and manifest content analysis. Phase 2 was an electronic close-ended survey to capture residents' primary motivation for requesting EPAs and importance of EPAs for learning. Survey data were analyzed descriptively. Results Of 120 eligible residents, 25 (21%) and 107 (89%) participated in the interview and survey, respectively. Program requirement was the dominant motivation for obtaining EPAs. There was variability in perceived importance of EPAs on learning. Increased resident workload, gaming the system to maximize EPA scores, and lack of shared ownership from preceptors were cited as critiques of the curriculum. Survey responses corroborated interview findings. Conclusions Although many residents recognize the value of EPAs, the majority are not intrinsically motivated to seek out assessment under the current CBME framework.

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Date Created: 20240712 Date Completed: 20240712 Latest Revision: 20240714

20240714

PMC11234313

10.4300/JGME-D-23-00470.1

38993299