Pilot implementation of Entrustable Professional Activities (EPAs) for Competency based Assessment in Undergraduate Medical Education in Community Medicine

Introduction: By directly observing real-world professional tasks, Entrustable Professional Activities (EPAs) make competency-based assessment possible. There is very less structured use of EPAs in undergraduate community medicine. The study's objectives were to develop, validate and pilot test an EPA module for Community Medicine among undergraduate students. Methods: Over the course of five months, single-center prospective interventional pilot research was carried out at the Punjab Institute of Medical Sciences' Department of Community Medicine in Jalandhar. Experts developed an EPA module titled "Assessment of nutritional status in a 3-year-old child," which was which had milestones in the emotional, cognitive, and psychomotor domains. The Item-Content Validity Index (I-CVI) and Scale-Content Validity Index (S-CVI) were evaluated. Direct Observation of Procedural Skills with entrustment levels was used to evaluate thirty Phase III Part I MBBS students. Feedback from students and faculty was obtained. Results: The EPA module showed high content validity, with I-CVI values ranging from 0.86 to 1.00 and an overall S-CVI of 0.94. Most students achieved entrustment level ≥3 for height (86.7%), weight (83.3%), MUAC measurement (73.3%), informed consent (80.0%), and communication skills (76.7%). Clinical judgement demonstrated lower entrustment, with 66.7% achieving Level ≥3 and 20.0% reaching Level 4. Student satisfaction rate was 86.7%, while all faculty expressed satisfaction. EPA feasibility was reported by 83.3% of students and 85.7% of faculty. Key challenges included time constraints, assessor calibration, and learner orientation. Conclusion: The EPA module was found to have strong validity, high satisfaction and feasibility among both students and faculty.