Entrustable Professional Activities
The American Board of Surgery (ABS) is currently in the early stages of a pilot study evaluating an EPA based assessment framework for General Surgery training. A collaborative effort with representatives from key stakeholder groups developed five EPAs for General Surgery:
- Evaluation and management of gallbladder disease
- Inguinal hernia
- Right lower quadrant pain
- Provide a general surgical consultation
- Initial evaluation of a trauma patient
These EPAs are currently being utilized in a pilot study at 28 diverse residency training programs across the United States, including ours. This pilot has primarily focused on identifying barriers and supporting factors to implementation, as well as innovation in data collection and reporting.
Although we are implementing all 5 EPAs, we are focusing on general surgical consultation and initial evaluation of a trauma patient. In addition to investigating how to collect and best use micro-assessment data, we are also focusing on issues around resident self-assessment and the utility of micro-assessments provided by other providers and specialists, such as APPs and educators in Emergency and Hospitalist Medicine.
OpTust Multi-site study
Our OpTrust work looks at faculty-resident teaching and interactions in the operating room. We will be exploring entrustment with national collaborators at the University of Michigan, Oregon Health & Science University, University of Rochester and the University of Alabama. The study seeks to better understand how entrustment behaviors in the operating room are informed by motivational styles and goal attainment strategies. Specifically, we are hoping to learn more about how promotion/prevention motivational goal attainment styles affect entrustment between faculty and residents in the operating room.
SECOND Trial – Resident Wellness
We are participating in the Surgical Education Culture Optimization through targeted interventions based on National comparative Data (SECOND) Trial, conducted by the Surgical Outcomes and Quality Improvement Center (SOQIC) at Northwestern Medicine in conjunction with the ACGME, ACS, and ABS. The Flexibility in duty-hour Requirements for Surgical Trainees (FIRST) Trial, found that 22% of U.S. general surgery residents reported weekly burnout symptoms, and that numerous aspects of the learning environment, not just duty hours, drive poor well-being. Currently, programs have no data about their performance on these issues compared to others in the country.
The SECOND Trial will begin with a national mixed-methods analysis to examine a variety of programs with respect to the learning environment and resident wellness. Lessons learned from these programs will be incorporated into a multidimensional Wellness Toolkit. The SECOND Trial will be a prospective, pragmatic cluster-randomized trial in which programs will be given a Program-Specific Report of their performance data, then randomized to receive the Wellness Toolkit with implementation support to determine how best to improve the learning environment and resident well-being. UW has been selected as a data collection site for the initial mixed-methods analysis and will then continue to participate in the randomized trial.