The use of EPA assessments in decision-making: Do supervision ratings correlate with other measures of clinical performance?

Background Entrustable professional activities (EPAs) have been introduced as a framework for teaching and assessment in competency-based educational programs. With growing use, has come a call to examine the validity of EPA assessments. We sought to explore the correlation of EPA assessments with other clinical performance measures to support use of supervision ratings in decisions about medical students' curricular progression. Methods Spearman rank coefficients were used to determine correlation of supervision ratings from EPA assessments with scores on clerkship evaluations and performance on an end-of-clerkship-year Objective Structured Clinical Examination (CPX). Results Both overall clinical evaluation items score (rho 0.40; n = 166) and CPX patient encounter domain score (rho 0.31; n = 149) showed significant correlation with students' overall mean EPA supervision rating during the clerkship year. There was significant correlation between mean supervision rating for EPA assessments of history, exam, note, and oral presentation skills with scores for these skills on clerkship evaluations; less so on the CPX. Conclusions Correlation of EPA supervision ratings with commonly used clinical performance measures offers support for their use in undergraduate medical education. Data supporting the validity of EPA assessments promotes stakeholders' acceptance of their use in summative decisions about students' readiness for increased patient care responsibility.

Automated summary

This study found a significant correlation between medical students' supervision ratings in EPA assessments and their clinical performance evaluations and CPX scores, supporting the use of supervision ratings in decisions about students' curricular progression.