Table 1.

Summary of Two Entrustable Professional Activity (EPA) Assessments Piloted in an Internal Medicine Residency

EPA title	Discharge EPA	Family meeting EPA
EPA description	Develop and implement a safe discharge plan for an inpatient from the acute care setting	Observe a family meeting to discuss serious or sensitive news with patient and/or family
PGY level	PGY-1 to PGY-2	PGY-1 to PGY-2
Curriculum	• 1-hour didactic on writing discharge summaries	• 1 week Palliative Care Rotation includes participating in family meetings and goals of care discussions
	• Two 1-hour noon conferences on safe patient discharge–didactic and small group exercise	• 1-hour noon conference on running a family meeting
	• 1-hour interactive session for interns to review peers’ discharge summaries and give feedback	• Online modules and selected papers for self-directed learning as part of the 2-hour long critical reflection exercise
	• Monthly PGY-1 ward orientations, includes site specific key elements of patient discharge
Setting	4-week inpatient general medicine ward rotation at University Hospital	1-week inpatient palliative care rotation at Veterans Affairs hospital
Activity	For initial activity, PGY-1 discharges ward patient, including completing discharge summary	PGY-1 observes a family meeting
		PGY-2/3s lead family meeting
Assessment	• EPA rubric completed by ward attending with PGY-1	• PGY-1 writes a critical reflection based on observations of a family meeting
	• PGY-1 reflection in portfolio	• PGY-1 receives written feedback on reflection from pre-specified faculty/fellows
		• PGY-2 and PGY-3s observed leading at least three serious illness conversations and receive structured, timely feedback

PGY post-graduate year intern