The use of EPA assessments in decision-making: Do supervision ratings correlate with other measures of clinical performance?

Abstract

Background

Entrustable professional activities (EPAs) have been introduced as a framework for teaching and assessment in competency-based educational programs. With growing use, has come a call to examine the validity of EPA assessments. We sought to explore the correlation of EPA assessments with other clinical performance measures to support use of supervision ratings in decisions about medical students’ curricular progression.

Methods

Spearman rank coefficients were used to determine correlation of supervision ratings from EPA assessments with scores on clerkship evaluations and performance on an end-of-clerkship-year Objective Structured Clinical Examination (CPX).

Results

Both overall clinical evaluation items score (rho 0.40; n = 166) and CPX patient encounter domain score (rho 0.31; n = 149) showed significant correlation with students’ overall mean EPA supervision rating during the clerkship year. There was significant correlation between mean supervision rating for EPA assessments of history, exam, note, and oral presentation skills with scores for these skills on clerkship evaluations; less so on the CPX.

Conclusions

Correlation of EPA supervision ratings with commonly used clinical performance measures offers support for their use in undergraduate medical education. Data supporting the validity of EPA assessments promotes stakeholders’ acceptance of their use in summative decisions about students’ readiness for increased patient care responsibility.

Keywords:

• Clinical
• clinical skills
• undergraduate
• medicine

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Notes on contributors

Victor Soukoulis

Victor Soukoulis, MD, PhD, is the Program Director of the Cardiovascular Disease Fellowship and Associate Professor in the Division of Cardiovascular Medicine, University of Virginia School of Medicine.

James Martindale

James Martindale, PhD, is the Director of Assessment and Associate Professor of Medical Education, Office of Medical Education, Center for Medical Education Research and Scholarly Innovation, University of Virginia School of Medicine.

Megan J. Bray

Megan J. Bray, MD, is the Associate Dean for Curriculum and Associate Professor of Obstetrics and Gynecology, Office of Medical Education, Center for Medical Education Research and Scholarly Innovation and Department of Obstetrics and Gynecology, University of Virginia School of Medicine.

Elizabeth Bradley

Elizabeth Bradley, PhD, is the Director of Curriculum Evaluation and Associate Professor, Office of Medical Education, Center for Medical Education Research and Scholarly Innovation, University of Virginia School of Medicine.

Maryellen E. Gusic

Maryellen E. Gusic, PhD, is the Senior Advisor for Educational Affairs and a Professor of Medical Education and Pediatrics, Office of Medical Education, Center for Medical Education Research and Scholarly Innovation and Department of Pediatrics, University of Virginia School of Medicine.