Entrustable Professional Activities in endocrine surgery: A national pilot study

Introduction: The American Association of Endocrine Surgeons drafted Entrustable Professional Activities for Comprehensive Endocrine Surgery to assess trainees in core topics.

Methods: Fourteen Entrustable Professional Activities were defined. There were 10 "core" Entrustable Professional Activities, with 6 having 3 phases (pre-, intra-, and postoperative) and 4 having a single phase. There were also 4 elective Entrustable Professional Activities, all of which had 3 phases. Beginning in July 2022, 10 institutions collected 3-item microassessments of trainee performance in Entrustable Professional Activities using a web-based platform. Entrustment was measured on a 5-point scale.

Results: A total of 698 microassessments were submitted between July 2022 and September 2023, with a wide range between programs (3-449, median: 24). Four-hundred ninety-two microassessments were completed for endocrine surgery fellows, 6 for chief residents, 6 for postgraduate year 4 students, 166 for postgraduate year 3 students, and 28 for postgraduate year 2 students. Entrustment scores for fellows improved in the second half of the academic year, with 38.2% of microassessments with highest (4/5) entrustment scores in the first 6 months of the academic year and 80.1% with highest scores in the second half of the year (P < .001). Intraoperative entrustment scores were lowest in the adrenal category, with only 13 of 117 (11.1%) of microassessments with highest entrustment compared with 85 with 230 (37.0%) in the thyroid category, and 65 of 165 (39.4%) in the parathyroid category (P < .001). Trainees were more likely to achieve highest entrustment in the first 6 months for preoperative (36/70, 28.5%) and postoperative (15/28, 53.5%) phases of care, compared with the intraoperative phase of care (79/334, 23.6%) (P < .001).

Conclusion: Entrustment scores improved in the second half of the academic year, and trainees were likely to achieve entrustment earlier in nonoperative phases of care.