Who can do this procedure? Using entrustable professional activities to determine curriculum and entrustment in anesthesiology – An international survey

Abstract

Introduction

As competency-based curricula get increasing attention in postgraduate medical education, Entrustable Professional Activities (EPAs) are gaining in popularity. The aim of this survey was to determine the use of EPAs in anesthesiology training programs across Europe and North America.

Methods

A survey was developed and distributed to anesthesiology residency training program directors in Switzerland, Germany, Austria, Netherlands, USA and Canada. A convergent design mixed-methods approach was used to analyze both quantitative and qualitative data.

Results

The survey response rate was 38% (108 of 284). Seven percent of respondents used EPAs for making entrustment decisions. Fifty-three percent of institutions have not implemented any specific system to make such decisions. The majority of respondents agree that EPAs should become an integral part of the training of residents in anesthesiology as they are universal and easy to use.

Conclusion

Although recommended by several national societies, EPAs are used in few anesthesiology training programs. Over half of responding programs have no specific system for making entrustment decisions. Although several countries are adopting or planning to adopt EPAs and national societies are recommending the use of EPAs as a framework in their competency-based programs, few are yet using these to make “competence” decisions.

Keywords:

• Entrusted professional activities
• EPA
• anesthesiology training
• medical education

Acknowledgments

The authors would like to thank all respondents who returned the questionnaire and the following national societies for their help in distributing the survey to anesthesiology training program directors: in Switzerland the Swiss Association for Anesthesiology and Reanimation, in Canada the Royal College of Physicians and Surgeons of Canada, Anesthesiology Specialty Committee, and in the USA the Academic Association of Anesthesiology and Perioperative Medicine.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Glossary

An Entrustable professional activity (EPA): Is a unit of professional practice that can be fully entrusted to a resident, as soon as he or she has demonstrated the necessary competence to execute this activity unsupervised (ten Cate 2005).

Data availability statement

The data associated with the paper are available from the corresponding author.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Christoph S. Burkhart

Christoph S. Burkhart, MD, is an anesthesiologist, responsible for the training program of anesthesiology at Kantonsspital Graubunden, Chur, Switzerland. This survey is part of his master thesis in Medical Education at the University of Berne, Switzerland.

Salome Dell-Kuster

Salome Dell-Kuster, MD, MSc, is an anesthesiologist at University Hospital Basel and senior scientist at the Basel Institute of Clinical Epidemiology and Biostatistics.

Claire Touchie

Claire Touchie, MD, is a Professor in the Department of Medicine and Department of Innovation in Medical Education at the University of Ottawa, Canada.