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Scoping Review of Entrustable Professional Activities in Undergraduate Medical Education

Meyer, Eric G. MD; Chen, H. Carrie MD, PhD; Uijtdehaage, Sebastian PhD; Durning, Steven J. MD, PhD; Maggio, Lauren A. PhD

doi: 10.1097/ACM.0000000000002735
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Purpose Entrustable professional activities (EPAs) are a hot topic in undergraduate medical education (UME); however, the usefulness of EPAs as an assessment approach remains unclear. The authors sought to better understand the literature on EPAs in UME through the lens of the 2010 Ottawa Conference Criteria for Good Assessment.

Method The authors conducted a scoping review of the health professions literature (search updated February 2018), mapping publications to the Ottawa Criteria using a collaboratively designed charting tool.

Results Of the 1,089 publications found, 71 (6.5%) met inclusion criteria. All were published after 2013. Forty-five (63.4%) referenced the 13 Core Entrustable Professional Activities for Entering Residency developed by the Association of American Medical Colleges (AAMC). Forty (56.3%) were perspectives, 5 (7.0%) were reviews, and 26 (36.6%) were prospective empirical studies. The publications mapped to the Ottawa Criteria 158 times. Perspectives mapped more positively (83.7%) than empirical studies (76.7%). Reproducibility did not appear to be a strength of EPAs in UME; however, reproducibility, equivalence, educational effect, and catalytic effect all require further study. Inconsistent use of the term “EPA” and conflation of concepts (activity vs assessment vs advancement decision vs curricular framework) limited interpretation of published results. Overgeneralization of the AAMC’s work on EPAs has influenced the literature.

Conclusions Much has been published on EPAs in UME in a short time. Now is the time to move beyond opinion, clarify terms, and delineate topics so that well-designed empirical studies can demonstrate if and how EPAs should be implemented in UME.

E.G. Meyer is assistant professor, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-0538-4344.

H.C. Chen is professor, Department of Pediatrics, Georgetown University School of Medicine, Washington, D.C.; ORCID: https://orcid.org/0000-0003-1663-1598.

S. Uijtdehaage is professor, Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0001-8598-4683.

S.J. Durning is professor, Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

L.A. Maggio is associate professor, Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-2997-6133.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University of the Health Sciences, the Department of Defense, or the U.S. Government.

Previous presentations: Center for Innovation and Leadership in Education (CENTILE) Education Colloquium, May 30, 2018, Georgetown University, Washington, D.C.; Association for Medical Education in Europe (AMEE) Conference, August 27, 2018, Basel, Switzerland; Association of American Medical Colleges (AAMC) Webinar September 24, 2018.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A667, http://links.lww.com/ACADMED/A668, and http://links.lww.com/ACADMED/A669.

Correspondence should be addressed to Eric G. Meyer, Department of Psychiatry, USUHS, 4301 Jones Bridge Rd., Bethesda, MD 20814; email: eric.meyer@usuhs.edu.

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

© 2019 by the Association of American Medical Colleges