Setting standards of performance expected in neurosurgery residency: A study on entrustable professional activities in competency-based medical education.

BACKGROUND

Competency-based medical education requires evaluations of residents' performances of tasks of the discipline (ie. entrustable professional activities (EPAs)). Using neurosurgical Faculty perspectives, this study investigated whether a sample of neurosurgical EPAs accurately reflected the expectations of general neurosurgical practice.

METHOD

A questionnaire was sent to all Canadian neurosurgery Faculty using a SurveyMonkey® platform.

RESULTS

The proportion of respondents who believed the EPAs were representative of general neurosurgery competences varied significantly across all EPAs [47%-100%] (p < 0.0001). For 9/15 proposed EPAs, ≥75% agreed they were appropriate for general neurosurgery training and expected residents to attain the highest standard of performance. However, a range of 27-53% of the respondents felt the other six EPAs would be more appropriate for fellowship training and thus, require a lower standard of performance from graduating residents.

CONCLUSION

The shift towards subspecialization in neurosurgery has implications for curriculum design, delivery and certification of graduating residents.