Great Expectations: A Discourse Analysis of Entrustable Behaviors in the EPA (Entrustable Professional Activities) Curriculum Developer's Guide

• In Event: Confronting Hidden Barriers to Inclusivity and Safety in the Learning Environment

Abstract

Competency-based medical education requires professional judgment, however, unarticulated criteria for entrustability privilege students with previous insider knowledge. Guided by Freirean notions of emancipatory education and conscientization, this study unpacks professional expectations through a comparative and functional linguistic analysis of competencies in the AAMC’s Curriculum Developer’s Guide to Core Entrustable Professional Activities. Findings show that for a single observed behavior assessors are expected to make numerous professional judgments spanning multiple domains, often several at a time. Yet, little guidance is provided to concretize those expectations, leaving ambiguity for both learners and yfaculty. Greater articulation of the professional biases used to judge learner competence can complement efforts to reduce unintended bias and ensure more equitable access to and assessment of medical practice.

Authors

• Abigail W. Konopasky, Dartmouth College

• Meghan Odsliv Bratkovich, University of South Florida - Tampa

• Todd A. Bates, Columbia University, College of Physicians and Surgeons