65.24 Sequential Implementation of EPAs at a Multi-Site Academic Surgical Residency

K. W. Von Schimmelmann1, F. Egawa1, P. J. Schenarts1, W. Al-Refaie1, D. Mukkai-Krishnamurty1  1Creighton University Medical Center, Omaha, NE, USA

Introduction 

The American Board of Surgery (ABS) implemented Entrustable Professional Activities (EPAs) to provide competency-based assessments to surgical trainees starting in July 2023 using the SIMPL application. The goal for the first year of EPAs is progressive and timely evaluations by faculty and residents. At this time there are no validated effective implementation strategies of EPAs among academic general surgery residency programs across the US. The purpose of this study is to create a stepwise multi-phasic implementation plan to accelerate the adoption of EPAs at the resident and faculty-level, with the goal to complete at least 3 EPAs per resident per week which would provide residents graduating in 2028 more than 700 evaluations. 

 

Methods 

Preliminary data on SIMPL application usage at a large academic multi-site general surgery residency program demonstrated an EPA completion rate of 0.23 evaluations per resident per week over the first month despite having 100% of the residents and 80% of the faculty with active accounts for the SIMPL application. Given the poor evaluation rate on the SIMPL app, an EPA workgroup was selected from a group of education experts, faculty members, and residents to develop a survey for faculty and residents to identify barriers and improvement opportunities for EPA implementation.  A prospective quantitative analysis of utilization of the SIMPL application will be performed along with the survey administered monthly at a 5-site academic general surgery program. The EPA workgroup will identify improvement opportunities and design strategies based on survey results to guide implementation throughout the adoption process.  

 

Results 

This study outlines a multi-phase EPA implementation plan based on a survey tool and monthly analysis of SIMPL application utilization. This simple strategy can be curated to each institution’s unique needs to increase EPA adoption and identify potential confounding factors. 

 

Conclusions

This toolkit and survey can be used to uncover barriers and variations during the EPA implementation period across all general surgery residency programs. This implementation strategy serves as a guidance to programs to generate hunderds of EPA evaluations prior to graduation.