Design, implementation and evaluation of novel work-based clinical assessment tool: An e-portfolio with embedded Entrustable Professional Activities

Highlights: •Entrustable Professional Activities (EPAs) define work done by health professionals •EPAs address competency assessment challenges in the clinical environment •EPAs embedded in an e-portfolio are well accepted by students and supervisors •EPAS demonstrate face validity, feasibility and acceptability Background A new concept in work-based assessment, Entrustable Professional Activities (EPAs) describe key activities a work-ready practitioner can perform independently. EPAs are widely used in medicine to support competency-based education and are gaining acceptance in other professions such as nursing, pharmacy and dietetics. There is currently no widely accepted work-based assessment tool for student clinical placement assessment in dietetics and EPAs offer potential to address this gap. Objectives To design, implement and evaluate a work-based assessment tool using EPAs embedded in an e-portfolio for use in clinical dietetics. Setting An accredited dietetic training program in Australian university and affiliated metropolitan and rural hospitals. Participants Three consecutive cohorts of final year dietetic students (n = 126) and their professional placement supervisors (n = 101). Methods A working party consisting of dietetic academics with experience in clinical dietetics and education developed clinical dietetic EPAs and milestones that were mapped to the National Competency Standards for Dietitians in Australia. A design model incorporating multiple rounds of user feedback was used to create an e-portfolio with the EPAs embedded. Students and supervisors were invited to complete anonymous on-line surveys with Likert responses (1 = highly dissatisfied, 5 = highly satisfied) to evaluate the face validity, acceptability and feasibility of the tool. Results A total of 37 EPAs were developed with an accompanying four-point entrustment scale to measure performance. Evaluation survey response rates were high and ranged from 35 to 45% for students and 57-83% for supervisors across the study period. Both students and supervisors evaluated the tool positively with a mean overall satisfaction of 4.12 ± 0.69 and 4.03 ± 0.68, respectively. Survey items evaluating face validity, feasibility and acceptability scored >3.75 for both groups of users. Conclusions The EPA based e-portfolio demonstrated face validity, feasibility and acceptability and offers potential for a widely accepted tool for work-based assessment of clinical dietetic students.