Back to 2026 Abstracts
A Qualitative Assessment Of Faculty Feedback Content In A National Cohort Of Epa Assessments
Cesar Delgado, MS1, Ting Sun, PhD
2, Katie Glasgow, MD
2, Oraya Vesvoranan, MD
3, Courtney Morgan, MD
3, Paul DiMusto, MD
3, M. Libby Weaver, MD, MHPE
2, Brigitte K. Smith, MD, MHPE
3.
1University of Wisconsin School of Medicine and Public Health, Madison, WI, USA,
2University of Utah Department of Surgery, Salt Lake City, UT, USA,
3University of Wisconsin Department of Surgery, Madison, WI, USA.
OBJECTIVES: High-quality performance feedback is critical to guide vascular surgery trainees’ skill development. Workplace-based assessment of Entrustable Professional Activities (EPA) allow faculty frequent opportunities to document narrative feedback. ACGME Milestones were mapped to each EPA and accompanying behavioral anchors reflect the range of competencies. It is unclear how faculty use this information to focus their feedback. We sought to identify the core competencies reflected in narrative feedback in a multi-institutional study of EPA assessments.
METHODS: EPA assessments were collected in a national Vascular Surgery EPA Pilot in 2024. EPAs were rated on a 4-point Likert scale including limited participation, direct supervision, indirect supervision and practice ready. Assessments included entrustment score, postgraduate year (PGY), phase of care (pre, intra, or post-operative), and narrative feedback. Narrative feedback was qualitatively analyzed using focused coding guided by the Vascular Surgery Milestones 2.0 framework. Comments were mapped to the six ACGME Core Competencies—patient care (PC), medical knowledge (MK), professionalism (PROF), interpersonal and communication skills (ICS), practice-based learning and improvement (PBLI), and systems-based practice (SBP)—to characterize the domains emphasized in feedback. Quality assessment scores were assigned to all narrative feedback using the Quality of Assessment of Learning (QuAL) framework. Descriptive analysis was completed using R.
RESULTS: Faculty completed 983 assessments across 19 institutions (n=17 residencies, n=13 fellowships). Narrative feedback was included in 759 (77%) assessments. Feedback most frequently addressed PC (n=666, 88%), followed by MK (n=478, 63%), PBLI (n=349, 46%), and PROF (n=174, 23%), whereas feedback about ICS (n=103, 14%) and SBP (n=74, 10%) were far less common. (Figure) SBP feedback was least often providedfor intra-operative EPAs (n=44, 7%), and more often for preoperative (n=15, 29%), and postoperative (n=15, 36%) phase of care EPA assessments. Compared with other competencies, SBP feedback was more often low quality (77%).
CONCLUSIONS: In this multi-institutional study of vascular surgery EPA assessments, faculty most frequently provided feedback on PC and MK competencies. Feedback on performance related to SBP was infrequently provided and, when provided, was of generally low quality. This has important implications for the use of EPAs to inform ACGME Milestones and suggests alternative assessment tools will continue to be needed.
Back to 2026 Abstracts
