Use of the electrodiagnostic entrustable professional activity for competency assessment in Physical Medicine and Rehabilitation training programs.

Entrustable Professional Activities (EPAs) have emerged as a means for the evaluation of resident competency that is expressed in terms of the assessed need for supervision. Recently, nineteen Physical Medicine and Rehabilitation specific EPAs were published6. The electrodiagnostic (EMG) EPA and six new EMG EPA subcategories (Observable Practice Activities or OPAs) were piloted as an EPA/OPA set within five residency programs. Survey-based (quantitative) and open-ended (qualitative) feedback was collected from participants. Participating attendings found this method feasible and generally reported satisfaction with the EPA/OPAs as a means of providing feedback to residents. Residents were less clear on the added value of this approach. Qualitative data supported the need for adjustments to the entrustment scale to allow for more gradations within supervisory levels, a standardized orientation of residents to the use of OPAs and an increased quantity of assessments for each OPA category in order to allow for demonstration of resident progress towards independence. Use of the EMG EPA/OPA set shows promise as a means for observational competency assessment the outpatient setting. However, feedback acquired through this pilot study suggests changes that could be made to improve future implementation.