Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99

Abstract

This Guide was written to support educators interested in building a competency-based workplace curriculum. It aims to provide an up-to-date overview of the literature on Entrustable Professional Activities (EPAs), supplemented with suggestions for practical application to curriculum construction, assessment and educational technology. The Guide first introduces concepts and definitions related to EPAs and then guidance for their identification, elaboration and validation, while clarifying common misunderstandings about EPAs. A matrix-mapping approach of combining EPAs with competencies is discussed, and related to existing concepts such as competency milestones. A specific section is devoted to entrustment decision-making as an inextricable part of working with EPAs. In using EPAs, assessment in the workplace is translated to entrustment decision-making for designated levels of permitted autonomy, ranging from acting under full supervision to providing supervision to a junior learner. A final section is devoted to the use of technology, including mobile devices and electronic portfolios to support feedback to trainees about their progress and to support entrustment decision-making by programme directors or clinical teams.

Assessment Pearls for Competency-Based Medical Education

“…For example, 1 EPA for internal medicine is ''admit and manage a medical inpatient with a new acute problem on a medical floor.'' 3,4 Several competencies are required for a resident to complete this EPA: knowledge of basic science, clinical features and management strategies, as well as communication skills and the ability to perform an appropriately focused physical examination. For each competency, a sampling strategy is required.…”

Improving workplace-based assessment and feedback by an E-portfolio enhanced with learning analytics

“…To this end, in our design approach, users from professional domains (e.g., experts and learners in medical, veterinary and teacher education) were consulted by means of Delphistudies and seven focus groups (n participants = 78) to determine what workplace-related tasks need to be assessed and what types of evidence (e.g., products, performance scores, process descriptions) should go in the E-portfolio (Jonker et al 2015;Ten Cate et al 2015;Wisman-Zwarter et al 2016). In addition, literature studies to develop workplace-based markers were carried out (Duijn et al 2016;Krull and Leijen 2015).…”

“…Based on E-portfolio data, a supervisor can provide text-based and numerical feedback and assessments at specific points during a learner's learning trajectory regardless of one's location or work schedule. The feedback and assessments provide input for diverse forms of credentials, for instance in the form of certificates or badges that reflect mastery of learning goals by learners (e.g., LindervanBerschot and Summers 2015;Schmidt-Crawford et al 2014;Ten Cate et al 2015).…”

Core Entrustable Professional Activities for Entering Residency Pilot Group Update: Considerations for Medical Science Educators

“…Entrustable professional activities (EPAs) describe units of work that represent routine activities of physicians, as distinguished from competencies, which describe observable abilities of an individual [3]. Both constructs are important to fostering the development of trainees.…”

“…If, however, the performance is not satisfactory, it is helpful to refer back to the associated competencies to provide clear feedback and develop a plan for improvement. EPAs together constitute the core activities of the professional [3].…”