Developing specialty-specific entrustable professional activities in medical education

What is it about?

This paper describes a comprehensive five stage approach to develop two specialty-specific in emergency medicine focused on the first year of general medical education training programs. In graduate medical education Entrustable professional activities (EPAs) have been identified as an approach to bridge the gap between the theoretical aspects of competency-based education and real world clinical practice. EPAs can be used by supervisors to contextualise abstract competencies in real world practice, to meaningfully assess the progress and capabilities of new graduates, and provide clearer expectations for students regarding the clinical tasks they will be required to perform as graduates. Further, EPAs also offer curriculum developers and teachers tangible goals for aligning teaching and training with clinical practice, across the continuum from Undergraduate Medical Education to Graduate Medical Education. EPAs are context specific, they articulate the competence levels that new doctors are expected to progress through within their training in particular medical disciplines.

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Why is it important?

A rigorous methodology for producing the specific content for the different sections of EPAs is lacking, such as determining the required knowledge, skills and attitudes for particular tasks. Although general guidance for designing the content of EPAs has been provided in previous literature, descriptions of the process lack sufficient detail for effective and consistent implementation, particularly with regard to determining content sources. For example, guidelines on defining the required knowledge, skills and attitudes suggest referring to manuals, books, protocols or instruction booklets but most reports do not explain who chooses this content and how. a rigorous methodology for the second step: producing the actual content for the different sections of EPAs, such as the required knowledge, skills and attitudes for particular tasks. Although general guidance for designing the content of EPAs has been provided in previous literature [13, 30], descriptions of the process lack sufficient detail for effective and consistent implementation, particularly with regard to determining content sources. For example, guidelines on defining the required knowledge, skills and attitudes suggest referring to manuals, books, protocols or instruction booklets [13, 30] but most reports do not explain who chooses this content,