Implementation of an assessment based on entrustable professional activities in a surgery medical residency program

Objective: Analyze the implementation of an entrustable professional activity (EPA) based assessment in the general surgery residency program at a university hospital. Methods: This was an exploratory descriptive study. Information on the steps of implementing the new assessment method was obtained from institutional documents. The residents' performance was extracted from academic records. Perceptions of residents and preceptors of the EPA-based assessment were obtained with an online questionnaire at the end of the process. Results: Six residents and eight preceptors participated in the study. The preceptors assigned 110 ad-hoc entrustment decisions during the study period. A Clinical Competency Committee (CCC) assigned a statement of awarded responsibility to each resident for each EPA. The expected entrustment level was achieved by two first-year residents in the postoperative EPA and one second-year resident in the preoperative EPA. The main competency gap was knowledge of theoretical foundations and commitment to punctuality and attendance. The perception analysis showed residents and preceptors' broad acceptance of the new assessment method. The EPA-based assessment was perceived as easy to understand, fair, and valuable in promoting feedback and learning. Conclusion: Implementation of EPA-based assessment in a general surgery residency is feasible and it was widely accepted by residents and preceptors.