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Competencies, Milestones, and a Level of Supervision Scale for Entrustable Professional Activities for Scholarship

Mink, Richard B., MD, MACM; Myers, Angela L., MD, MPH; Turner, David A., MD; Carraccio, Carol L., MD, MA

doi: 10.1097/ACM.0000000000002353
Innovation Reports

Problem Scholarship is an important element of both undergraduate and graduate medical education, and scholarly activity is required for all pediatric fellows. However, despite the creation of entrustable professional activities (EPAs) for scholarship, the specific progressive levels of performance and the appropriate level of supervision for a given performance level have not been defined. The authors developed competencies and milestones for the scholarship EPA to provide a framework for assessment across the continuum; a level of supervision scale was also developed.

Approach The Vitae Researcher Development Framework served as a template to create the competencies and milestones for the scholarship EPA. Beginning in September 2015 and using a modified Delphi approach, three drafts were circulated to individuals with expertise in various types of scholarship until broad agreement was achieved. Then, in October 2016, the Steering Committee of the Subspecialty Pediatrics Investigator Network created a level of supervision scale, modeled after one it had previously developed.

Outcomes Eight competencies were identified as important in making entrustment decisions related to scholarship. For each competency, five milestone levels that span the continuum from novice to expert were created. A supervision scale with five progressive levels of entrustment was also created.

Next Steps Next steps include a study to obtain validity evidence for the supervision scale and determine the correlation between milestone and supervision levels. These competencies, milestones, and supervision levels can potentially serve as a road map for trainees and junior faculty and also play a role in the assessment of physician–scientists.

R.B. Mink is professor of pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, California, and director, Pediatric Critical Care Medicine Fellowship, Harbor-UCLA Medical Center, Torrance, California; ORCID:

A.L. Myers is associate professor and director, Infectious Diseases Fellowship Program, Children’s Mercy Hospital and University of Missouri–Kansas City School of Medicine, Kansas City, Missouri; ORCID:

D.A. Turner is associate professor of pediatrics, Duke University School of Medicine, and associate director of graduate medical education, Duke University Medical Center, Durham, North Carolina.

C.L. Carraccio is vice president of competency-based assessment, American Board of Pediatrics, Chapel Hill, North Carolina.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Previous presentations: Presented in its entirely as a poster at the Association of Pediatric Program Directors Annual Spring Meeting, Anaheim, California, April 5–8, 2017.

Correspondence should be addressed to Richard B. Mink, Harbor-UCLA Medical Center, 1000 W. Carson St., Box 491, Torrance, CA 90509; telephone: (310) 222-4002; e-mail:

© 2018 by the Association of American Medical Colleges