ImportanceEntrustable professional activities (EPAs) compose a competency-based education (CBE) assessment framework that has been increasingly adopted across medical specialties as a workplace-based assessment tool. EPAs focus on directly observed behaviors to determine the level of entrustment a trainee has for a given activity of that specialty. In this narrative review, we highlight the rationale for EPAs in general surgery, describe current evidence supporting their use, and outline some of the practical considerations for EPAs among residency programs, faculty, and trainees.ObservationsAn expanding evidence base for EPAs in general surgery has provided moderate validity evidence for their use as well as practical recommendations for implementation across residency programs. Challenges to EPA use include garnering buy-in from individual faculty and residents to complete EPA microassessments and engage in timely, specific feedback after a case or clinical encounter. When successfully integrated into a program’s workflow, EPAs can provide a more accurate picture of residents’ competence for a fundamental surgical task or activity compared with other assessment methods.Conclusions and RelevanceEPAs represent the next significant shift in the evaluation of general surgery residents as part of the overarching progression toward CBE among all US residency programs. While pragmatic challenges to the implementation of EPAs remain, the best practices from EPA and other CBE assessment literature summarized in this review may assist individuals and programs in implementing EPAs. As EPAs become more widely used in general surgery resident training, further analysis of barriers and facilitators to successful and sustainable EPA implementation will be needed to continue to optimize and advance this new assessment framework.

中文翻译：

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值得信赖的外科专业活动

重要性可信赖的专业活动 (EPA) 构成了基于能力的教育 (CBE) 评估框架，该框架已越来越多地被医学专业采用作为基于工作场所的评估工具。EPA 侧重于直接观察到的行为，以确定受训者对该专业的特定活动的信任程度。在这篇叙述性综述中，我们强调了普通外科中 EPA 的基本原理，描述了支持其使用的当前证据，并概述了住院医师计划、教师和实习生中 EPA 的一些实际考虑因素。 观察 普通外科中 EPA 的证据基础不断扩大提供了其使用的中等有效性证据以及跨住院医师计划实施的实用建议。使用 EPA 的挑战包括获得个别教职人员和居民的支持，以完成 EPA 微观评估，并在病例或临床遇到后及时提供具体反馈。当成功融入项目的工作流程时，与其他评估方法相比，EPA 可以更准确地描述住院医师完成基本外科任务或活动的能力。结论和相关性EPA 代表了普通外科住院医师评估的下一个重大转变，作为美国所有住院医师项目中向 CBE 的总体进展。虽然实施 EPA 的务实挑战仍然存在，但本次审查中总结的 EPA 和其他 CBE 评估文献中的最佳实践可能有助于个人和项目实施 EPA。随着 EPA 在普外科住院医师培训中得到更广泛的应用，需要进一步分析成功和可持续实施 EPA 的障碍和促进因素，以继续优化和推进这一新的评估框架。