Dr. Brenessa Lindeman
UAB was recently selected as a pilot site for the American Board of Surgery’s Entrustable Professional Activities project, making our General Surgery Residency Program one of only 26 programs in the U.S. piloting the use of the EPAs framework in residency evaluation for the American Board of Surgery.
General Surgery Residency Associate Program Director Brenessa Lindeman, M.D., M.E.H.P., explained that the existing framework for residency education has struggled to accurately assess resident competence and that the new model hopes to create a more learner-centric education system for residents.
Dr. John Porterfield
“Our current system of residency training relies on surrogate metrics for competency, such as the amount of time spent on procedures and the number of procedures completed,” Lindeman said. “Competency-based medical education relies on defining the knowledge and skills required for a surgeon to practice without supervision and helps residents work toward those goals in a more transparent way.”
Residency programs that are adopting this new EPA model must adapt their curricula to provide trainees with more real-time feedback about their ability to perform certain tasks and treat certain diseases independently. Therefore, Lindeman and General Surgery Residency Program Director John Porterfield, M.D., have worked with the American Board of Surgery to refocus resident training experiences on predefined outcomes, using a framework that encompasses competencies, milestones and EPAs, instead of just clinical staffing requirements.
@UABSurgery Team enthusiastically embracing the ABS EPA Pilot Program. pic.twitter.com/SQfSQWAEwz
— Dr. John Porterfield (@PorterfieldJohn) March 5, 2018
“Defining the outcomes of training at the beginning allows residents to take a more active role in their education,” Lindeman said. “Rather than just putting in a certain amount of time, they can see and track the areas in which they’ve made substantial progress and the areas in which they still need more refinement.”
Because the new framework relies on evaluations from both residents and faculty to assess resident competency, Porterfield said that both groups will have to learn how to give and receive focused, constructive feedback and to work as educational partners. As part of this pilot, Porterfield and Lindeman are studying novel methods to evaluate surgical trainees in the context of EPAs.
“EPAs are the next step in the modern evolution of resident assessment, and we are methodically studying their implementation and impact as we focus on providing the highest-quality care to our patients,” Porterfield said.
Lindeman was also recently awarded a 2018 Research and Innovations in Medical Education Faculty Development Award, which will provide up to $7,500 in funding for her to attend a professional development course related to this project.
Read more about EPAs and competency-based medical education here.