ORIGINAL RESEARCH Use of Large-Group Patient Rounds to Characterize Pre-clerkship Medical Students’ Ability to Perform Three Entrustable Professional Activities N. R. Chamberlain 1,2 & P. S. Sexton 1 & M. R. Hardee 1 & R. W. Baer 1 Published online: 27 May 2016 # International Association of Medical Science Educators 2016 Abstract The pre-clerkship years of medical school focus on providing a foundation in the basic health sciences. Students then build on this foundation to perform clinical skills that include the American Association of Medical College’s entrustable professional activities (AAMC EPAs) targeted at day 1 of residency. A variety of educational experiences that link competencies with AAMC EPAs are needed. We used large-group physician-mentored patient rounds (PMPRs) to assess the development of three AAMC EPAs in pre- clerkship second year medical students. We focused on (1) prioritizing a differential diagnosis (AAMC EPA 2), (2) order- ing diagnostic tests (AAMC EPA 3), and (3) prescribing treat- ments (AAMC EPA 4). We designed the PMPR described here to follow a COPD patient through history-taking, physi- cal examination, ordering diagnostic tests, and prescription of treatments. The exercise was administered to 158 students during weekly half-hour sessions across 5 weeks. Student as- signments focused on AAMC EPAs 2, 3, and 4. Student re- sponses were collected, summarized, and shared back with critical physician appraisal of the Baggregate student thinking.^ Students generally produced appropriate differen- tial lists (AAMC EPA 2) but often exhibited naïve approaches. Students also tended to order too many and inappropriate di- agnostic tests. The physician guidance resulted in students ordering fewer and more appropriate diagnostic tests (AAMC EPA 3) as the exercise progressed. Students also developed generally appropriate treatment plans (AAMC EPA 4), but a few students prescribed potentially dangerous medications which became teaching points. Large-group PMPR is an effective method for assessment of pre- clerkship medical students’ ability to perform AAMC EPAs and provides a valuable opportunity to nurture the clinical skills that are foundational to those entrustable professional activities that should be achieved before day 1 of residency. Keywords Entrustable professional activities . Clinical reasoning . Large group physician mentored patient rounds . Clinical skills . Pre-clerkship medical students Introduction A major goal of undergraduate medical education (UME) is to provide medical students with the measurable medical knowl- edge, skills, values, and attitudes (competencies) they need to begin their residencies [1]. The learning experiences utilized to accomplish that task are diverse due to the diverse nature of the competencies medical students need to begin their residen- cies. To become competent health care providers, students also must learn to combine the competencies essential for managing patient care [2]. An interprofessional team commissioned by the AAMC developed a list of 13 entrustable professional activities (EPAs) that medical school graduates should be able to per- form on the first day of residency [1]. The performance of any given AAMC pre-residency EPA requires that several differ- ent competencies be combined and used at the same time. For example, AAMC pre-residency EPA 2 (Prioritize a differential diagnosis following a clinical encounter) requires proficiency in eight competencies within five different domains of * N. R. Chamberlain nchamberlain@atsu.edu 1 Kirksville College of Osteopathic Medicine, A.T. Still University of Health Sciences, Kirksville, MO, USA 2 Department of Microbiology, A.T. Still University of Health Sciences, 800 W. Jefferson St, Kirksville, MO 63501, USA Med.Sci.Educ. (2016) 26:481–489 DOI 10.1007/s40670-016-0265-4