EMYWAY Workplace-Based Entrustable Professional Activities Assessments in Otolaryngology Residency Training: A Nationwide Experience

EMYWAY基于工作场所的可信赖专业活动评估在耳鼻喉科住院医师培训中的应用:一项全国性经验

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Abstract

OBJECTIVE: To present workplace-based entrustable professional activities (EPAs) assessment data from the first 2 years of the EMYWAY platform in otolaryngology residency training in Taiwan. STUDY DESIGN: Two-year cross-sectional study. SETTING: Otolaryngology training programs. METHODS: In 2020, the Taiwan Society of Otorhinolaryngology-Head and Neck Surgery (TSO-HNS) developed a workplace-based assessment (WBA) framework with 11 EPAs, integrating milestones to evaluate resident competency. In 2021, TSO-HNS piloted the EMYWAY platform for WBAs, which includes an EPA-based assessment workflow, coaching feedback, and a dashboard displaying residents' entrustment-supervision levels. Data are analyzed annually for accreditation and curriculum enhancement. This study reports on the pilot year and the first full-scale year of implementation. RESULTS: Eleven programs participated in the pilot year. Subsequently, 362 faculty members and 274 resident physicians from 34 programs nationwide engaged with EMYWAY. In the full-scale year from August 2022 to July 2023, 9805 responses were recorded, primarily from surgical theaters (45.9%; 4502/9805) and third-year residents (23.8%; 2331/9805). The most frequently evaluated EPAs were "head and neck" (17.5%; 1716/9805), "sinonasal" (13.5%; 1324/9805), and "ear" (12.2%; 1193/9805), with task complexity increasing with resident seniority (P < .0001). A positive correlation was found between residents' self-assessments and faculty members' ratings (r = 0.531; P < .001). Over 98.2% of residents and 88.4% of faculty members provided substantial feedback (>10 words). Analysis of WBAs reported by training programs identified faculty development targets and teaching-intensive tasks. CONCLUSION: EMYWAY effectively documents workplace learning and tracks resident competency progression. Continuous improvement of WBA quality is essential for advancing the competency-based medical education ecosystem.

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