Feb. 14, 2022
The American Board of Surgery (ABS), the national certifying body for general surgeons and related specialists, is pleased to introduce the ABS Entrustable Professional Activities (EPA) Project, which will launch in July 2023 for general surgery residency programs.
The ABS began exploring EPAs as a potential foundation for competency-based surgical training and initial board certification in 2016, following several years of discussion around various strategies to improve traditional time-based residency training models. The ABS then developed five index EPAs and piloted them at 28 diverse surgical residency programs from 2018-2020. With the onset of the COVID-19 pandemic in early 2020, it became more apparent than ever that a move to competency-based assessment is necessary to appropriately determine trainee readiness to enter the ABS certification process. Supported by pilot-informed best practice insights, the ABS is developing a full suite of EPAs to form the foundation for competency-based assessment of general surgery trainees.
Over the next 18 months, the ABS will continue to collaborate with key surgical education partners and stakeholders across the nation to refine the lessons learned from the EPA pilot experience into a full suite of approximately 19 EPAs representative of the core elements of general surgical practice. The EPAs will allow meaningful, frequent, and longitudinal assessment of individual resident performance and preparation for autonomous and competency-based practice.
"The EPA project has tremendous potential to reframe the culture of surgical training, and to honor and enfranchise in daily behavior our Hippocratic commitment to pass on knowledge, skill and professional character to those who follow, for the service of the public and the greater good," said Dr. John Mellinger, ABS Vice President and executive leader of the ABS EPA Project.
The ABS will develop a mobile-based technology platform to allow for time-efficient, feedback-oriented assessment of resident performance in the course of daily workflow. The platform – along with faculty and resident development tools – will be composed, provided, and deployed free of charge to all ACGME-accredited general surgery training programs. The ABS will also employ published scholarship, workshops, and presentations at key surgical education venues to support faculty and residents as they prepare to engage in this new assessment paradigm.
The ultimate goal of deploying EPAs is to create a habit of workplace-based micro-assessment and improvement-oriented performance feedback linked to core competencies and milestones that help fulfill every surgeon’s commitment to honor the public trust.
In pursuing this goal, the ABS looks forward to partnering with the full spectrum of the profession and fellow educational organizations – and most especially with faculty colleagues and trainees themselves. The ABS aims to incorporate this strategy into a new paradigm for surgical training focused on educational outcomes, with a view to excellence and the highest standards in patient care.
EPAs are also in the early stages of development for the other ABS specialties, including vascular surgery, pediatric surgery, complex general surgical oncology, and surgical critical care, with plans to introduce this trainee assessment model to those specialty programs in the coming years as well.
Check back over the next few months for a new section of the ABS website that will be dedicated to EPAs, and will include videos, documents, and publications with background information on EPAs, findings from the ABS EPA Pilot, and plans for the future of competency-based surgical trainee assessment.