Using entrustable professional activity scores for ward round performance assessment of internists in internal medicine: A comparative study of two medical training models

Background: The shift to competency-based medical education stresses entrustable professional activities (EPAs) as a framework for assessing trainees’ competence for autonomous practice via specific professional tasks. This study examined the effectiveness of two training programs for acquiring internal medicine competencies: the conventional model and the Collaborative Project to Increase Rural Doctor Production (CPIRD) in a rural teaching hospital. Methods: A comparative study of 88 first-year internal medicine interns (64 conventional, 24 CPIRD) was conducted at Sakon Nakhon Hospital, Thailand. EPA assessments were based on Thai Medical Council (TMC) criteria and scored on a five-level scale. Statistical analyses were performed to compare group differences in EPA performance. Results: Total EPA scores were similar between the conventional (4.42±0.498) and CPIRD (4.46±0.509) groups (P=0.381). The conventional group performed better in EPA 3 (Differential diagnosis) and EPA 5 (Prescription management) (P=0.036, P=0.034), while the CPIRD group excelled in EPA 6 (Basic procedural skills). No significant demographic factors influenced above-average EPA scores. Conclusion: Both training models effectively develop overall competency in internal medicine. Differences in specific EPAs suggest that rural-based training enhances procedural skills, while conventional training strengthens diagnostic and management abilities. Tailored curricula could further optimize training outcomes.