251 - Venturing into the Unknown: Pediatric Residents’ Perceptions of Entrustable Professional Activities (EPAs)

Publication Number: 251.7061

Renae Simons, Dayton Children's Hospital, Dayton, OH, United States; Thomas M. Bertagnoli, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Fairborn, OH, United States; Ann E.. Burke, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; Eric Whitney, Dayton Children's Hospital, Dayton, OH, United States; Wendla Sensing, Dayton Children's Hospital, Dayton, OH, United States; Caitlin E. Hammond, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; Emily A. Friedl, Dayton Children's Hospital, dayton, OH, United States; Zachary Ross, Dayton Children's Hospital, Dayton, OH, United States; Michelle Kiger, University of Colorado School of Medicine, Highlands Ranch, CO, United States; Jennifer Hilgeman, Dayton Children's Hospital, OH, OH, United States

Background: By 2028, the American Board of Pediatrics (ABP) will require pediatric residency programs to transition from assessing pediatric trainees on the ACGME Milestones to Entrustable Professional Activities (EPAs). Current studies in pediatric EPAs focus on their validity and correlation to the milestones, but few focus on resident perceptions of EPAs (Kerth et al., 2022; Schumacher et al., 2021; Smit et al., 2019).

Objective: Our study aims to explore a medium-sized pediatric residency learners’ baseline understanding and perceptions of the ABP’s EPAs, and to assess whether these perceptions correlate with their Clinical Competency Committee evaluations.

Design/Methods: We obtained IRB approval for a mixed-method design; first we conducted an 11-item Likert-scale survey on knowledge, perceptions, and preferences regarding EPAs and Milestones and analyzed descriptive statistics on results. Residents then reviewed 5 EPAs (#2, 3, 4, 9 & 10), rated themselves on these EPAs, and provided written justification of their ratings. We performed a weighted kappa correlation on resident self-ratings compared to clinical competency committee (CCC) ratings as well as a content analysis of self-rating justifications.

Results: Thirty-three of 48 (69%) pediatric trainees from all 3 levels of training participated. Survey results demonstrated the majority were not familiar with EPAs or Milestones, and they therefore had no preferences for one or the other (Fig 1). Weighted kappa analysis demonstrated moderate agreement between self-ratings and CCC ratings (Fig 2). Content analysis revealed most residents justified their ratings based on general sense of confidence with limited objective evidence.

Conclusion(s): Our study highlights a significant gap in pediatric trainees' understanding of EPAs and therefore limited insights into how their implementation can enhance their training. Despite limited knowledge, they appeared able to understand them enough to self-rate in moderate agreement with CCC ratings. These findings suggest EPA implementation should be feasible, but we need to further study resident perceptions and understanding to inform how programs can implement them in a way that residents will view as value added to their learning.

Disclosure: The views in this article are those of the authors alone and do not reflect those of the United States Air Force, Defense Health Agency, Department of Defense, or United States Government.

Resident Familiarity of EPAs versus Milestones


Resident Preference Between EPAs versus Milestones


Agreement Between Resident Self-Rating and CCC Ratings on ABP EPAs