Wong Lye-Yeng, Lam Nathan, Son Yewon Ashley, Eddington Hyrum, Arnow Katherine D, Tsai Jason, Anand Ananya, Peralta Fatyma C, Shields Samuel, Melcer Edward F, Lin Dana T, Liebert Cara A
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California 94305.
Department of Surgery, Stanford University School of Medicine, Palo Alto, California, 94305.
J Surg Educ. 2025 Jan;82(1):103293. doi: 10.1016/j.jsurg.2024.09.012. Epub 2024 Nov 11.
With the implementation of American Board of Surgery (ABS) Entrustable Professional Activities (EPAs), there is continued need for objective, evidence-based assessment tools to augment existing microassessments and inform readiness for entrustment. The ENTRUST Assessment Platform is an online virtual-patient simulation platform to assess trainees' surgical decision-making competence across preoperative, intraoperative, and postoperative phases of care. This study collects additional validity evidence for the ENTRUST platform in its relationship to other established variables in competency-based surgical education.
This is a prospective analysis of surgical resident performance on the ENTRUST Right Lower Quadrant (RLQ) pain/Appendicitis EPA Assessment. ENTRUST scores were analyzed by PGY-level and correlations with Accreditation Council for Graduate Medical Education (ACGME) Case Logs, ACGME Surgery Milestones, and ABS In-Service Training Examination (ABSITE) scores were evaluated. Bivariate analyses were performed using Spearman rank correlations.
This study was conducted at a tertiary academic center (Stanford University, Palo Alto, CA) in a proctored exam setting.
Thirty-two PGY-1 though PGY-5 general surgery residents completed the ENTRUST RLQ Pain/Appendicitis EPA Assessment containing four case scenarios which were iteratively developed and scored by expert consensus and aligned with ABS EPA definitions.
ENTRUST grand total score was positively correlated with PGY-level (rho = 0.57, p = 0.001), ACGME appendectomy case log volume (rho = 0.55, p = 0.002), and ABSITE raw score (rho = 0.66, p = 0.0004). ENTRUST performance was significantly correlated with all eighteen ACGME Surgery Milestones (rho = 0.43 to rho = 0.54, all p≤0.01), with the strongest correlation seen for PC1 (Patient Evaluation and Decision Making) (rho = 0.54, p = 0.006).
Performance on ENTRUST was significantly correlated with established variables in surgical training, including ACGME Appendectomy Case Logs, ABSITE, and ACGME Surgery Milestones. This study strengthens existing validity evidence for the ENTRUST Assessment Platform as an objective assessment of clinical decision-making. ENTRUST is an assessment tool which can augment microassessments and support competency-based medical education.
随着美国外科委员会（ABS）可托付专业活动（EPA）的实施，持续需要客观的、基于证据的评估工具来补充现有的微观评估，并为托付准备情况提供参考。ENTRUST评估平台是一个在线虚拟患者模拟平台，用于评估学员在术前、术中和术后护理阶段的手术决策能力。本研究收集了ENTRUST平台与基于能力的外科教育中其他既定变量关系的额外效度证据。
这是一项对住院医师在ENTRUST右下腹（RLQ）疼痛/阑尾炎EPA评估中的表现进行的前瞻性分析。ENTRUST分数按住院医师培训阶段（PGY）进行分析，并评估其与毕业后医学教育认证委员会（ACGME）病例记录、ACGME外科学里程碑以及ABS在职培训考试（ABSITE）分数的相关性。使用Spearman等级相关性进行双变量分析。
本研究在一所三级学术中心（加利福尼亚州帕洛阿尔托的斯坦福大学）的监考考试环境中进行。
32名PGY-1至PGY-5的普通外科住院医师完成了ENTRUST RLQ疼痛/阑尾炎EPA评估，该评估包含四个病例场景，这些场景经过反复开发，并由专家共识评分，且与ABS EPA定义一致。
ENTRUST总分与PGY水平呈正相关（rho = 0.57，p = 0.001）、与ACGME阑尾切除病例记录量呈正相关（rho = 0.55，p = 0.002）以及与ABSITE原始分数呈正相关（rho = 0.66，p = 0.0004）。ENTRUST表现与所有18个ACGME外科学里程碑均显著相关（rho = 0.43至rho = 0.54，所有p≤0.01），其中与PC1（患者评估与决策制定）的相关性最强（rho = 0.54，p = 0.006）。
ENTRUST的表现与外科培训中的既定变量显著相关，包括ACGME阑尾切除病例记录、ABSITE和ACGME外科学里程碑。本研究强化了ENTRUST评估平台作为临床决策客观评估的现有效度证据。ENTRUST是一种可以补充微观评估并支持基于能力的医学教育的评估工具。
