Is It Time for Entrustable Professional Activities for Residency Program Directors?

Abstract

Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position. Based on personal observations as PDs and communications with others in the academic medicine community, the authors used work in competency-based medical education to define a list of potential EPAs for PDs. The benefits of developing these EPAs include being able to define competencies for PDs using a deconstructive process, highlighting the increasingly important role PDs play in leading high-quality graduate medical education programs, using EPAs as a framework to assess PD performance and provide feedback, allowing PDs to focus their professional development efforts on the most important areas for their work, and helping guide the PD recruitment and selection processes.

Development of an entrustable professional activities (EPAs) framework for small group facilitators through a participatory design approach

“…Another potential benefit of this framework is that it can serve as a guide for recruitment and promotion of facilitators [20]. For this purpose, one proposed method is granting a 'statement of awarded responsibility' (STAR) to the teacher demonstrating sufficient proficiency in an EPA [2].…”

“…For the past decade, much work has been done in developing and implementing EPAs in both undergraduate [17] and postgraduate [18] medical training programs. Some studies have reported the utility of EPAs for simulation leaders [19], program directors [20], and scholars [21]. Most recently, EPAs have been introduced for training health professional educators [22,23] and family medicine teachers [24].…”

Implementing a logbook on entrustable professional activities in the final year of undergraduate medical education in Germany – a multicentric pilot study

“…Overarching goals of clinical electives are clearly stated and foster a better understanding and concreteness of needed clinical skills [12], [13]. On the one side, the students know what they can expect from their ward training, and on the other side, the supervisors also know which professional activities they can entrust to the students.…”

Graduate Programs in Health Professions Education: Preparing Academic Leaders for Future Challenges

“…Some have proposed that it may be time for a set of entrustable professional activities (EPAs) for residency program directors. 7 As the TABLE illustrates, most of these EPAs map well to the core competency areas addressed in the typical MHPE program. Moreover, many MHPE programs can be tailored to the learner's needs and interests, and specific tracks can be crafted to further enhance the relevance of the MHPE degree to GME leadership activities.…”

“…4 In addition, with the advent of the Next Accreditation System and the Clinical Learning Environment Review program, program directors are expected to thoroughly understand how to review curriculum, grow and develop educational expertise among their own faculty, and create and maintain a robust evaluation system for milestones reporting. 7,9,10…”