Anjali Jagannathan, BSc.

While our STEPS competency framework effectively defines the knowledge, skills, and attitudes (KSAs) essential for the non-clinical SOS role, these competencies remain intrinsic attributes that are difficult to observe and measure in real-world practice, potentially compromising the reliability of assessment. A promising solution, commonly used in medical education, involves grounding assessment frameworks in EPAs, which translate KSAs into observable tasks aligned with workforce demands and emphasize their personalized, time-variable entrustment. Within this model, trainees are granted progressive autonomy as they demonstrate readiness for transfer of responsibility, supporting workforce readiness upon graduation. 

While  EPA-based assessment has proven successful in health professions education, its application in non-clinical contexts, including non-clinical SOS training and undergraduate education, remains underexplored. Thus, the overarching aim of my research is to adapt, develop, and prepare to implement an EPA-based assessment framework for emerging university-based non-clinical SOS training programs like STEPS. 

The questions guiding my research are: 

1. How can an EPA-based assessment framework be adapted and developed to support progressive competency development and reliable assessment in university-based non-clinical SOS training?
2. How can an implementation strategy be co-created to optimize the likelihood of the framework’s successful uptake within university-based training programs like STEPS?

To accomplish this aim, my work follows a three-phase approach:

• Phase 1 (Theory and Evidence Identification): I am currently conducting a scoping review to map the diffusion of EPAs beyond their origins in medical education, identify strategies for adaptation in novel contexts, and understand contextual factors influencing successful adoption in non-clinical training contexts. 

• Phase 2 (Framework Modelling): I am currently developing the assessment framework through continuous engagement with university leadership and simulation experts across Canada. This process involves: (1) defining a set of professional activities (PAs) that encapsulate the non-clinical SOS role and mapping them to our STEPS competency framework; (2) developing an EPAs framework based on this mapping; (3) designing strategies and tools to effectively develop and assess competence and entrustability across didactic, simulation, and work-integrated learning curricular components; (4) scaling the assessment framework to fit the STEPS minor; and (5) co-creating implementation tools to support  framework's successful uptake.

• Phase 3 (Piloting and Pre-Implementation) : Once developed, I plan to pilot the assessment framework with a cohort of STEPS trainees and conduct interviews and focus groups to assess perceived feasibility, acceptability, and contextual relevance. These insights will guide refinements to both the framework and its implementation strategy. 

Ultimately, this work will result in an EPA-based assessment framework and implementation strategy for university-based non-clinical SOS training programs like STEPS.  We anticipate that this framework will enhance the quality of simulation-based health professions education by supporting the training and integration of workforce-ready non-clinical SOS into the simulation ecosystem, while also providing a replicable model for broader scaling and adoption in university-based programs in diverse fields.