Entrustment and Practice Readiness: Learner Experiences With Implementing Longitudinal Assessment Using Entrustable Professional Activities

PURPOSE: To evaluate dental learner experiences with a longitudinal entrustment framework using Entrustable Professional Activities (EPAs) at the University of North Carolina at Chapel Hill Adams School of Dentistry (UNC ASOD). METHODS: A multi-methods design and convenience sampling were employed among fourth-year dental students (Class of 2025). Twenty-five learners (31% of class) completed a survey adapted from validated implementation outcome measures assessing acceptability, appropriateness, and feasibility. Eighteen of those learners (22%) also participated in three virtual focus groups. Guided by the Consolidated Framework for Implementation Research, data were analyzed to identify determinants and contextual factors influencing experiences of the assessment system. RESULTS: Survey results indicated learners found the system acceptable (82%), appropriate (82%), and feasible (70%) for assessing entrustment and practice readiness. Focus group participants expressed preference for longitudinal assessment over single high-stakes evaluations, noting the opportunity to track progress, identify areas for improvement, and support practice readiness. The institution's learner-centered values, provision of training, and positive faculty relationships were identified as facilitators of the system's success. Shared understanding between learners and faculty and the opportunity for continuous skill development influenced learner experiences and motivation to use the system. Balancing assessment volume, learner-faculty alignment, and both timely and constructive feedback were important to maximize the system's educational value. CONCLUSIONS: Learners viewed EPA-based longitudinal assessment as an authentic and learner-centered approach to determining practice readiness and motivation for ongoing skill refinement. Findings highlight the importance of addressing feasibility and shared understanding that supports implementation and sustainability in dental education.