Evaluation of the Quality of General Surgery Entrustable Professional Activities Using the EQual Rubric

OBJECTIVE: To apply the EQual rubric to the American Board of Surgery General Surgery EPAs in order to evaluate their quality and identify opportunities for refinement. DESIGN: The EPAs were evaluated using the EQual rubric by 4 current or former program directors. All items from the rubric which were shown to have generalizability were included in the assessment on 5-point Likert scales. Raters were trained to ensure consistent application of the rubric. Each participant independently completed the rubric and statistical analysis was performed. SETTING: Current or former program directors at tertiary academic centers. PARTICIPANTS: Raters were identified based on their leadership roles in general surgery programs and scholarship in surgical education research. RESULTS: The composite mean score of all EPAs was 4.63 (0.19), which is greater than the EQual study cutoff of 4.07 used to identify EPAs requiring major revisions. Each EPA also individually scored above this cutoff. However, 3 EPAs: Provide Surgical Consultation, Gastrointestinal Endoscopy, and Peri-operative Care of the Critically Ill Surgical Patient scored below the cutoff score for the Discrete Unit of Work domain. Each of these 3 EPAs additionally scored one or more standard deviations below the composite mean. CONCLUSIONS: While all of the ABS General Surgery EPAs scored above the major revision cutoff, 3 EPAs scored significantly lower than the others, indicating an opportunity for revisions or restructuring. Use of this objective tool could be valuable in the iterative development and revision of future EPAs.