gms | German Medical Science

Objective: Several countries have defined sets of Core Entrustable Professional Activities (EPAs) as end-of-training outcomes for undergraduate medical education. In Germany, a group of experts recently defined the content of such a set of Core EPAs that will be implemented at the national level in 2025 [https://www.nklm.de]. The presented study aims at adding validity evidence of the defined set of EPAs by exploring students’ learning curve over the course of their undergraduate studies.

Methods: In 2021, a survey was sent to students of all semesters of the undergraduate medical curriculum at the Charité – Universitätsmedizin Berlin, Germany. They were asked to voluntarily rate under which level of supervision they think to be able to perform the defined 13 Core EPAs and 10 Core Procedures in a patient safe manner. The supervision levels ranged from “not able to perform the EPA” to “I can perform the EPA autonomously, with remote monitoring and key findings being reviewed.” Descriptive statistics and correlational analyses were conducted.

Results: The data of students from semesters 1 to 10 (n=445; response rate 15%) were included in the data analyses (62% females; 37% males, mean age of 25). Results of the correlational analyses showed that the level of supervision decreased over the course of study for the majority of EPAs and procedures. The strength of the association ranged between r(411)=.110, p<0.05 and r(410)=.510, p<0.01. No association between the level of supervision and the semester could be found for the procedures “preparing medications for injection and infusion”, “basic immobilization and application of a bandage” and “performing septic and aseptic dressing changes”.

Discussion: The study provides complementary evidence for the validity of the defined set of Core EPAs, as students reported to be able to perform the majority of EPAs under a decreasing level of supervision in the course of their study. Variations in the strength of the associations between EPAs and semester can be used for discussing both the content of the undergraduate curriculum and the content of the EPAs themselves.

Take home message: Students’ learning curve over the course of study represent an easy to apply approach for yielding complementary validity evidence on the content of end-of-undergraduate-training EPAs.