An Evaluation of Entrustable Professional Activities in Undergraduate Medical Education

Entrustable professional activities (EPAs) are a hot topic in undergraduate medical education (UME); however, the usefulness of EPAs as an assessment approach remains unclear. The authors sought to better understand the literature on EPAs in UME through the lens of the 2010 Ottawa Conference Criteria for Good Assessment. The authors conducted a scoping review of the health professions literature (search updated February 2018), mapping publications to the Ottawa Criteria using a collaboratively designed charting tool. Of the 1,089 publications found, 71 (6.5 percent) met inclusion criteria. All were published after 2013. Forty-five (63.4 percent) referenced the 13 Core EPAs for Entering Residency developed by the Association of American Medical Colleges. Forty (56.3) were perspectives, five (7.0 percent) were reviews, and 26 (36.6 percent) were prospective empirical studies. The publications mapped to the Ottawa Criteria 158 times. Perspectives mapped more positively (83.7 percent) than empirical studies (76.7 percent). Reproducibility did not appear to be a strength of EPAs in UME; however, reproducibility, equivalence, educational effect, and catalytic effect all require further study. Inconsistent use of the term EPA and conflation of concepts (activity vs. assessment vs. advancement decision vs. curricular framework) limited interpretation of published results. Over-generalization of the AAMC's work on EPAs by other authors has influenced the literature.