The framework of EPAs went through many iterations before it was consolidated. Among the issues that required special attention was the application of a supervision levels scale for sign-off, the necessity to cover all relevant clinical content while not labeling too many small tasks each as a separate EPA, methods of EPA-focused assessment in the workplace and the creation of an e-portfolio model to serve assessment and entrustment.
van der Schaaf & Olle ten Cate (2020): EPA-based assessment: Clinical teachers' challenges when transitioning to a prospective entrustment-supervision scale, Medical Teacher,
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