Entrustment and mapping of observable practice activities for resident assessment

Eric J. Warm, Bradley R. Mathis, Justin D. Held, Savita Pai, Jonathan Tolentino, Lauren Ashbrook, Cheryl K. Lee, David Lee, Sharice Wood, Carl J. Fichtenbaum, Daniel Schauer, Ryan Munyon, Caroline Mueller

Research output: Contribution to journalReview articlepeer-review

90 Scopus citations


Entrustable Professional Activities (EPAs) and the Next Accreditation System reporting milestones reduce general competencies into smaller evaluable parts. However, some EPAs and reporting milestones may be too broad to use as direct assessment tools. We describe our internal medicine residency curriculum and assessment system, which uses entrustment and mapping of observable practice activities (OPAs) for resident assessment. We created discrete OPAs for each resident rotation and learning experience. In combination, these serve as curricular foundation and tools for assessment. OPA performance is measured via a 5-point entrustment scale, and mapped to milestones and EPAs. Entrustment ratings of OPAs provide an opportunity for immediate structured feedback of specific clinical skills, and mapping OPAs to milestones and EPAs can be used for longitudinal assessment, promotion decisions, and reporting. Direct assessment and demonstration of progressive entrustment of trainee skill over time are important goals for all training programs. Systems that use OPAs mapped to milestones and EPAs provide the opportunity for achieving both, but require validation.

Original languageEnglish (US)
Pages (from-to)1177-1182
Number of pages6
JournalJournal of general internal medicine
Issue number8
StatePublished - Aug 2014

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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