The Entrustable Professional Activities (EPAs) for a specialty define the core clinical activities that a resident should be deemed competent to perform independently by the conclusion of their training. Residents’ entrustability is observed during day-to-day patient care and assessed using Surgery Entrustable Professional Activities (SEPA), a locally developed smartphone application that allows faculty and residents to complete assessments in real time. In the assessment, the trainee and the faculty member select the applicable level of supervision (limited participation, direct supervision, indirect supervision, and practice ready) that the trainee demonstrated for that specific EPA. The goal is that trainees will achieve practice-ready entrustment for the core practice of their specialty.
In February 2022, the American Board of Surgery (ABS) announced the move to competency-based assessment of surgical trainees with the introduction of the ABS Entrustable Professional Activities (EPA) Project. At the national level, EPAs launched in July 2023 for general surgery residency programs, in August 2025 for vascular surgery, pediatric surgery, and complex general surgical oncology, and in September 2025 for surgical critical care. Wisconsin Surgery has been engaged in developing and launching EPAs at the local level prior to the formal ABS launch.
“The importance of education is simply in our DNA here at UW Surgery,” Dr. Brigitte Smith, Vice Chair of Education, said. “There is a decades-long tradition of educational excellence that all of us seek to uphold. All of our programs are built on that strong foundation, which enables our culture of educational excellence and innovation”
EPAs were developed to provide the opportunity for frequent, time-efficient, feedback-oriented workplace-based assessment in the course of daily clinical workflow. Trainees can use the analytics from EPA assessments to show faculty members where they are in terms of their progression, and faculty members can use EPA summative analytics to review a resident’s experiences to date, even if they have not worked with the resident before. Additionally, the narrative portion of the EPA assessments allow faculty to review feedback from other colleagues, so they can focus on areas for development for the trainee in a given case or clinical encounter.
Wisconsin Surgery has been a leader in the development and implementation of EPAs dating back to the initial pilot testing in 2018. The department’s adoption of EPAs was led by Dr. Rebecca Minter, A.R. Curreri Professor and Chair of the Department of Surgery. Dr. Minter was heavily involved in the ABS Entrustable Professional Activities Project, serving as a member of both the General Surgery EPA Advisory Council and Writing Group prior to the implementation of General Surgery EPAs in 2023. Several other Wisconsin Surgery faculty members have also been involved in impacting EPAs at the national level, demonstrating Wisconsin Surgery’s leadership in this area of surgical training.
Innovation has allowed Wisconsin Surgery to be at the forefront when it comes to collecting EPA assessment data. The Department of Surgery started using its in-house mobile application, SEPA, to collect EPA assessment data in July 2018. SEPA allows users to submit and review assessments, see real-time dashboard reports, use advanced report filters and receive notifications of missing assessments. Since this app was developed in-house, modifications can be made to adjust end user settings as needed. Users can also access a web application where they can see more detailed dashboards and analytics including assessment counts, graphs of EPA entrustment levels over time, summary of comments, trainee summary, and summative entrustment levels. The Wisconsin Surgery SEPA team is developing AI algorithms to provide directional feedback to trainees and the clinical competency committee regarding trainee progress based upon qualitative feedback.
Wisconsin Surgery’s strong commitment to educational excellence is demonstrated in the department’s strong engagement with EPAs and willingness to complete assessments. In 2025, there were 3,045 faculty assessments of trainees and 2,692 self-assessments by trainees. From the launch of SEPA on July 1, 2018 through the end of 2025, there were 10,124 faculty assessments of trainees and 9,437 self-assessments by trainees. The department encourages engagement by providing goals for the number of assessments that trainees and faculty members should complete, and by displaying a leader board featuring the names of faculty and trainees who have completed the most EPA assessments. Training the next generation of surgeons is an integral part of Wisconsin Surgery. Adopting and implementing EPAs is just another way that the Department of Surgery is committed to being at the forefront of training the next generation of excellent surgeons.