Entrustable Professional Activities: An Analysis of Faculty Time, Trainee Perspectives, and Actionability
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
The Royal College of Physicians and Surgeons of Canada introduced Competence by Design (CBD) as an educational model along with Entrustable Professional Activities (EPAs) as markers of achievement that could be directly observed on a frequent basis. In 2017, the University of Calgary Internal Medicine (IM) program piloted CBD. The purpose of this study was to (1) assess whether written feedback from EPAs were actionable, valuable, and disruptive to workflow and (2) assess the time required to complete an EPA. Methods Seven Foundations of Discipline EPAs were used with 31 PGY-1 Calgary IM residents. The study used quantitative and qualitative data. Following a discussion on an EPA and completion of both the quantitative and written feedback, residents were asked to comment on the value of the encounter and the degree of disruption to workflow. Assessors provided time to complete an EPA. Data were anonymized. Trainee comments were coded for value and disruption, and assessor's written feedback was coded for actionability. Results One hundred and five EPA encounters were submitted. The majority of the comments provided to trainees were not actionable (94.3%, n = 99/105). While most residents did not comment on value (73.3%, n = 77/105) or disruption (44.8%, n = 47/105) of the encounter, those that did generally found the encounters valuable (25.7%, n = 27/105) and nondisruptive (35.2%, n = 37/105). A minority found the process nonvaluable (1%, n = 1/105) and disruptive (20%, n = 21/105). The mean time to complete an EPA form and provide feedback was 8.6 min. Conclusion Most written feedback was not actionable, suggesting a potential role for faculty development to guide assessors and help them coach trainees on EPAs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it