Making EPAs a 59 Minute Objective Measure for Surgical Trainees – A Pilot Study

Abstract Introduction Accurately confirming surgical trainees have met the requirements of entrusted professional activities (EPAs) will require rigorous staff input. We pondered whether such simulation-driven evaluations might prove useful to the current ABS/APDS pilot effort on EPA analysis. Methods Our surgical trainees participate biannually in a 59-minute simulation-based assessment (X-Games) which covers surgical technique, knowledge and critical thinking in a host of domains. The content and difficulty of the stations differed between the PGY levels. Only 4 EPA topics (inguinal hernia repair, appendectomy, cholecystectomy, and trauma resuscitation) were tabulated for this study. Results 16-PGY-2s, 8-PGY-3s, 10-PGY-4s, and 10-PGY-5s surgical residents completed the X-Games. Performance within and between PGY levels was variable. The mean(SD) EPA scores for all PGY levels are listed in Table-1. Conclusion Analysis gleaned from a 59-minute OSCE in a simulated-setting offers objective data that appears to have construct-validity. Refining our Surgical X-Games to cater to the specific EPA scoring system may better allow objective analysis of when trainees cross the threshold from “can do with some help” to “can do autonomously”.