Evaluating the Impact of Entrustable Professional Activity Based Medical Student Teaching and Logbook Usage on Competence and Confidence in Peripheral Intravenous Cannulation

Introduction Entrustable Professional Activities (EPAs) are specific and measurable units of clinical practice used in competency-based training. Learners demonstrate skills to assessors who assign supervision levels for future practice. This study evaluated the impact of EPA-based assessment and logbook use on medical student performance and confidence in peripheral intravenous (IV) cannulation. Methods This multi-phase mixed methods study involved medical students attending a teaching course incorporating EPA-based teaching and assessment. Participants were divided into test and control groups. Self-assessed confidence scores and EPA levels were measured before and after the teaching course comparing logbook and non-logbook users. Thematic analysis of student and assessor feedback explored perceptions of EPA assessment and course effectiveness. Results Confidence scores significantly improved from pre-test (mean 2.91/5) to post-test (mean 4.05/5, p<0.001). Overall pass rates also significantly increased from 10% to 61.7% (p<0.001). However, no significant difference was observed in confidence or EPA scores between logbook users and non-users. Student feedback highlighted the value of practical teaching, tutor support and structured feedback. Challenges to logbook use included supervision availability and form completion logistics. Students and assessors vauled the EPA mark scheme for structured feedback and real-world relevance. Discussion EPA-based teaching was associated with improved competence and confidence through practical learning, structured feedback and progressive assessment. The lack of a demonstrated additional benefit from logbook use may reflect limited engagement and practical barriers to documentation. EPAs may provide a useful developmental framework for undergraduate procedural education, although optimisation of supervision, documentation and entrustment-level clarity may improve implementation. Conclusions EPA-based teaching significantly improved confidence and competence in IV cannulation, while EPA logbook use did not result in additional measurable benefits. Students and assessors valued practical experience, formative feedback and the EPA framework. Future implementation should address barriers to logbook engagement, supervision and documentation.