Validity Evidence for ENTRUST as an Assessment of Surgical Decision-Making for the Inguinal Hernia Entrustable Professional Activity (EPA).

Autor: Liebert CA; Department of Surgery, Stanford University School of Medicine, Stanford, California; VA Palo Alto Health Care System, Surgical Services, Palo Alto, California. Electronic address: cara.liebert@stanford.edu., Melcer EF; Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California., Keehl O; Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California., Eddington H; Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, California., Trickey AW; Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, California., Lee M; Stanford University School of Medicine, Stanford, California., Tsai J; Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California., Camacho F; Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California., Merrell SB; Department of Pediatrics, Stanford University School of Medicine, Stanford, California., Korndorffer JR Jr; Department of Surgery, Stanford University School of Medicine, Stanford, California; VA Palo Alto Health Care System, Surgical Services, Palo Alto, California., Lin DT; Department of Surgery, Stanford University School of Medicine, Stanford, California.
Jazyk: angličtina
Zdroj: Journal of surgical education [J Surg Educ] 2022 Nov-Dec; Vol. 79 (6), pp. e202-e212. Date of Electronic Publication: 2022 Jul 28.
DOI: 10.1016/j.jsurg.2022.07.008
Abstrakt: Objective: As the American Board of Surgery (ABS) moves toward implementation of Entrustable Professional Activities (EPAs), there is a growing need for objective evaluation of readiness for entrustment of residents. This requires not only assessment of technical skills and knowledge, but also surgical decision-making in preoperative, intraoperative, and postoperative settings. We developed and piloted an Inguinal Hernia EPA Assessment on ENTRUST, a serious game-based online virtual patient simulation platform to assess trainees' decision-making competence.
Design: This is a prospective analysis of resident performance on the ENTRUST Inguinal Hernia EPA Assessment using bivariate analyses.
Setting: This study was conducted at an academic institution in a proctored exam setting.
Participants: Forty-three surgical residents completed the ENTRUST Inguinal Hernia EPA Assessment.
Results: Four case scenarios for the Inguinal Hernia EPA and corresponding scoring algorithms were iteratively developed by expert consensus aligned with ABS EPA descriptions and functions. ENTRUST Inguinal Hernia Grand Total Score was positively correlated with PGY-level (p < 0.0001). Preoperative, Intraoperative, and Postoperative Total Scores were also positively correlated with PGY-level (p = 0.001, p = 0.006, and p = 0.038, respectively). Total Case Scores were positively correlated with PGY-level for cases representing elective unilateral inguinal hernia (p = 0.0004), strangulated inguinal hernia (p < 0.0001), and elective bilateral inguinal hernia (p = 0.0003). Preoperative Sub-Scores were positively correlated with PGY-level for all cases (p < 0.01). Intraoperative Sub-Scores were positively correlated with PGY-level for strangulated inguinal hernia and bilateral inguinal hernia (p = 0.0007 and p = 0.0002, respectively). Grand Total Score and Intraoperative Sub-Score were correlated with prior operative experience (p < 0.0001). Prior video game experience did not correlate with performance on ENTRUST (p = 0.56).
Conclusions: Performance on the ENTRUST Inguinal Hernia EPA Assessment was positively correlated to PGY-level and prior inguinal hernia operative performance, providing initial validity evidence for its use as an objective assessment for surgical decision-making. The ENTRUST platform holds potential as tool for assessment of ABS EPAs in surgical residency programs.
(Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: