Using a Curricular Vision to Define Entrustable Professional Activities for Medical Student Assessment

Abstract

Background: The new UCSF Bridges Curriculum aims to prepare students to succeed in today’s health care system while simultaneously improving it. Curriculum redesign requires assessment strategies that ensure that graduates achieve competence in enduring and emerging skills for clinical practice. Aim: To design entrustable professional activities (EPAs) for assessment in a new curriculum and gather evidence of content validity. Setting: University of California, San Francisco, School of Medicine. Participants: Nineteen medical educators participated; 14 completed both rounds of a Delphi survey. Program Description: Authors describe 5 steps for defining EPAs that encompass a curricular vision including refining the vision, defining draft EPAs, developing EPAs and assessment strategies, defining competencies and milestones, and mapping milestones to EPAs. A Q-sort activity and Delphi survey involving local medical educators created consensus and prioritization for milestones for each EPA. Program Evaluation: For 4 EPAs, most milestones had content validity indices (CVIs) of at least 78 %. For 2 EPAs, 2 to 4 milestones did not achieve CVIs of 78 %. Discussion: We demonstrate a stepwise procedure for developing EPAs that capture essential physician work activities defined by a curricular vision. Structured procedures for soliciting faculty feedback and mapping milestones to EPAs provide content validity.