Transdisciplinary entrustable professional activities

Abstract

Healthcare has become highly specialized. Specialists, in medicine as well as in nursing, determine much of the high quality of current health care. But healthcare has also become increasingly fragmented, with professionals trained in separate postgraduate silos, with boundaries often difficult to cross. While a century ago, generalists dominated patient care provision, now specialists prevail and risk becoming alienated from each other, losing the ability to adapt to neighboring professional domains. Current health care requires a flexible workforce, ready to serve in multiple contexts, as the COVID-19 crisis has shown.

The new concept of transdisciplinary entrustable professional activities, EPAs applicable in more than one specialty, was recently conceived to enhance collaboration and transfer between educational programs in postgraduate nursing in the Netherlands.

In this paper, we reflect on our experiences so far, and on practical and conceptual issues concerning transdisciplinary EPAs, such as: who should define, train, assess, and register transdisciplinary EPAs? How can different prior education prepare for similar EPAs? And how do transdisciplinary EPAs affect professional identity?

We believe that transdisciplinary EPAs can contribute to creating more flexible curricula and hence to a more coherent, collaborative healthcare workforce, less determined by the boundaries of traditional specialties.

Keywords:

• Entrustable professional activity
• transdisciplinary
• postgraduate nursing education
• postgraduate medical education
• CZO flex level

Acknowledgements

The authors wish to thank Dr. Carol Carraccio, emeritus professor of pediatrics at the University of Maryland School of Medicine, and Helma van Zundert, MBA and project manager of CZO Flex Level for comments on an earlier version of the manuscript.

Disclosure Statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Transdisciplinary entrustable professional activities (EPAs) are tasks, or units of professional practice, that apply to multiple disciplines or specialties.

Additional information

Funding

Inge Pool, Marieke van der Horst and Saskia Hofstra received financial support from the CZO Flex Level Project.

Notes on contributors

Inge Pool

Inge Pool, PhD, is an educationalist and researcher in nursing and medical postgraduate education at the Isala Academy, Isala hospitals, Zwolle, the Netherlands.

Saskia Hofstra

Saskia Hofstra, is a teacher and trainer in paramedical education and currently project manager “Implementation of EPA-based flexible education system” in the Health Academy, Erasmus Medical Center, Rotterdam, the Netherlands.

Marieke van der Horst

Marieke van der Horst, MSc, is a freelance educationalist in postgraduate medical and nursing education, currently project manager “Sustainable development and collaboration” at the Dutch Association of Medical Specialists, Utrecht, the Netherlands.

Olle ten Cate

Olle ten Cate, PhD, is a Professor of medical education and Senior Scientist at the Center for Research and Development of Education at University Medical Center Utrecht, the Netherlands.