Currently accepted at: JMIR Medical Education
Date Submitted: Nov 11, 2025
Open Peer Review Period: Nov 20, 2025 - Jan 15, 2026
Date Accepted: Mar 12, 2026
(closed for review but you can still tweet)
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/87605
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Medical Students' Acceptance of Digital Entrustable Professional Activities: Results of a Cohort Study
ABSTRACT
Background:
Digital Entrustable Professional Activities (EPAs) in simulated environments may accelerate competency acquisition, but adoption depends on learner acceptance. The Technology Acceptance Model (TAM) posits that perceived usefulness (PU) and perceived ease of use (PEU) shape attitudes (AT) and, in turn, behavioral intention (BI).
Objective:
We examined medical students’ acceptance of digital EPAs and tested the hypothesized TAM relationships among PU, PEU, AT, and BI.
Methods:
Clinical-phase medical students at Ludwig-Maximilians-Universität Munich completed a TAM-based survey (7-point Likert scales) after reading a canonical analog EPA and its digital counterpart. Confirmatory analyses comprised bivariate correlations, and hierarchical regressions testing TAM paths. Exploratory analyses comprised paired-sample t-tests comparing analog vs digital ratings and path modeling to evaluate global TAM fit.
Results:
N = 72 medical students provided complete responses per construct. Mean ratings were favorable (≈5/7). Internal consistency was acceptable (ω=.67–.80). Within the digital EPAs, PU strongly predicted AT (β=.59, p<.001), and AT predicted BI (β=.58, p<.001. For the analog EPAs, PU (β=.54, p<.001) and PEU (β=.28, p=.005) predicted AT; both AT (β=.42, p<.001) and PU (β=.36, p=.002) predicted BI. Attitudes were modestly higher for analog vs digital (M=5.18 vs 4.87; t(71)=−2.50, p=.015, d=−0.30) but PU, PEU, BI did not differ significantly. The path models indicated excellent fit for both formats (CFI=1.00; RMSEA=0.00; SRMR≤.01).
Conclusions:
Students reported high acceptance of digital EPAs. Acceptance was driven primarily by PU (via AT), whereas PEU contributed to AT only for analog EPAs. Implementation should emphasize demonstrable educational value and cultivate positive attitudes; subsequent work should link acceptance to actual use and learning outcomes. Clinical Trial: PRR1-10.2196/59326
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.