Evidence map›Paper›PMID 37789289›Full record

ArticleBMC medical education2023

Relationship between epa level of supervision with their associated subcompetency milestone levels in pediatric fellow assessment.

Richard B Mink, Carol L Carraccio, Bruce E Herman, Pnina Weiss, David A Turner, Diane E J Stafford, Kathleen A McGann, Jennifer Kesselheim, Deborah C Hsu, Pamela C High and 11 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medical education, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Richard B MinkDepartment of Pediatrics, David Geffen School of Medicine at UCLA and the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA, 90502, USA. rmink@ucla.edu.
Carol L CarraccioAmerican Board of Pediatrics, Chapel Hill, NC, USA.
Bruce E HermanUniversity of Utah School of Medicine, Salt Lake, UT, USA.
Pnina WeissDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
David A TurnerAmerican Board of Pediatrics, Chapel Hill, NC, USA.
Diane E J StaffordDivision of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Kathleen A McGannDepartment of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Jennifer KesselheimDana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
Deborah C HsuBaylor College of Medicine, Houston, TX, USA.
Pamela C HighAlpert Medical School of Brown University, Providence, RI, USA.
Jill J FussellUniversity of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR, USA.
Megan L CurranDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Patricia R ChessUniversity of Rochester, Rochester, NY, USA.
Cary SauerDepartment of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.
Sarah PittsDivision of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
Angela L MyersCenter for Wellbeing, Children's Mercy Hospital and University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
John D MahanDepartment of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.
Christiane E L DammannTufts Children's Hospital, Tufts University, Boston, MA, USA.
Tandy AyeDivision of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Alan SchwartzUniversity of Illinois College of Medicine at Chicago, Chicago, IL, USA.
Subspecialty Pediatrics Investigator Network

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEntrustable Professional Activities (EPA) and competencies represent components of a competency-based education framework. EPAs are assessed based on the level of supervision (LOS) necessary to perform the activity safely and effectively. The broad competencies, broken down into narrower subcompetencies, are assessed using milestones, observable behaviors of one's abilities along a developmental spectrum. Integration of the two methods, accomplished by mapping the most relevant subcompetencies to each EPA, may provide a cross check between the two forms of assessment and uncover those subcompetencies that have the greatest influence on the EPA assessment.

objectivesWe hypothesized that 1) there would be a strong correlation between EPA LOS ratings with the milestone levels for the subcompetencies mapped to the EPA; 2) some subcompetencies would be more critical in determining entrustment decisions than others, and 3) the correlation would be weaker if the analysis included only milestones reported to the Accreditation Council for Graduate Medical Education (ACGME).

methodsIn fall 2014 and spring 2015, the Subspecialty Pediatrics Investigator Network asked Clinical Competency Committees to assign milestone levels to each trainee enrolled in a pediatric fellowship for all subcompetencies mapped to 6 Common Pediatric Subspecialty EPAs as well as provide a rating for each EPA based upon a 5-point LOS scale.

resultsOne-thousand forty fellows were assessed in fall and 1048 in spring, representing about 27% of all fellows. For each EPA and in both periods, the average milestone level was highly correlated with LOS (rho range 0.59-0.74; p < 0.001). Correlations were similar when using a weighted versus unweighted milestone score or using only the ACGME reported milestones (p > 0.05).

conclusionsWe found a strong relationship between milestone level and EPA LOS rating but no difference if the subcompetencies were weighted, or if only milestones reported to the ACGME were used. Our results suggest that representative behaviors needed to effectively perform the EPA, such as key subcompetencies and milestones, allow for future language adaptations while still supporting the current model of assessment. In addition, these data provide additional validity evidence for using these complementary tools in building a program of assessment.

Indexed as

Education, Medical, GraduateInternship and ResidencyAccreditationChildClinical CompetenceCompetency-Based EducationHumansLanguageAssessmentCorrelationEPAsEquationsFellowMilestones

Identifiers

PMID37789289
PMCPMC10548580

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.