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Purpose <p>Entrustable Professional Activities (EPAs) serve as an assessment framework for core activities of general surgery to inform resident entrustment. Entrustment in general surgery (GS) training has demonstrated feedback and demographic differences. Here, we examine the relationship between GS trainees’ entrustment levels and receiving narrative EPA feedback as well as other assessment factors in the full EPA implementation phase.</p> Methods <p>In this multi-institution, retrospective study, all EPA assessments of GS trainees completed by faculty between July 2023 and June 2025 were analyzed. Mixed-effects ordinal regressions were performed to examine the association between entrustment and receiving narrative feedback, year of training, case complexity, assessment phase of care, and faculty and resident demographics.</p> Results <p>A total of 1071 assessments were analyzed with 896 EPAs (83.7%) containing narrative feedback and 175 EPAs (16.3%) without any feedback. Trainees performing at higher levels of entrustment for a given activity were less likely to receive narrative feedback (OR = 0.44,<i> p</i> &lt; 0.001). The likelihood of trainees receiving higher entrustment increased significantly with post-graduate year (PGY), reaching the highest entrustment likelihood in senior training stages. Trainees participating in straightforward cases were more likely to receive higher entrustment than those in complex cases (OR = 1.94, <i>p</i> = 0.002). Pre- and post-operative assessments were more likely granted higher entrustment than intraoperative phases (pre: OR = 4.94, <i>p</i> &lt; 0.001, post: OR = 3.04, <i>p</i> = 0.017). There was no difference in entrustment based on trainee or faculty demographics after controlling for PGY and case complexity.</p> Conclusion <p>Receipt of narrative feedback was associated with significantly lower odds of being in a higher entrustment category. Efforts should be made to ensure all residents receive actionable feedback along the continuum of their training.</p>

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The relationship between entrustment and EPA assessment factors in general surgery residency training

  • 期刊论文

  • 发表日期：

    2026年7月21日

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  • Gabrielle Moore,
  • Dalton Hegeholz,
  • Ting Sun,
  • M. Libby Weaver,
  • Erin P. Ward,
  • Erika Simmerman Mabes,
  • Kshama Jaiswal

摘要

Purpose

Entrustable Professional Activities (EPAs) serve as an assessment framework for core activities of general surgery to inform resident entrustment. Entrustment in general surgery (GS) training has demonstrated feedback and demographic differences. Here, we examine the relationship between GS trainees’ entrustment levels and receiving narrative EPA feedback as well as other assessment factors in the full EPA implementation phase.

Methods

In this multi-institution, retrospective study, all EPA assessments of GS trainees completed by faculty between July 2023 and June 2025 were analyzed. Mixed-effects ordinal regressions were performed to examine the association between entrustment and receiving narrative feedback, year of training, case complexity, assessment phase of care, and faculty and resident demographics.

Results

A total of 1071 assessments were analyzed with 896 EPAs (83.7%) containing narrative feedback and 175 EPAs (16.3%) without any feedback. Trainees performing at higher levels of entrustment for a given activity were less likely to receive narrative feedback (OR = 0.44, p < 0.001). The likelihood of trainees receiving higher entrustment increased significantly with post-graduate year (PGY), reaching the highest entrustment likelihood in senior training stages. Trainees participating in straightforward cases were more likely to receive higher entrustment than those in complex cases (OR = 1.94, p = 0.002). Pre- and post-operative assessments were more likely granted higher entrustment than intraoperative phases (pre: OR = 4.94, p < 0.001, post: OR = 3.04, p = 0.017). There was no difference in entrustment based on trainee or faculty demographics after controlling for PGY and case complexity.

Conclusion

Receipt of narrative feedback was associated with significantly lower odds of being in a higher entrustment category. Efforts should be made to ensure all residents receive actionable feedback along the continuum of their training.