Twelve tips for the implementation of EPAs for assessment and entrustment decisions

Abstract

The concept of entrustable professional activities (EPAs) reframes the approach to assessment in competency-based medical education. Key to this concept is the linking of assessment to decision making about entrusting learners with clinical responsibilities. Based on recent literature and the authors’ experiences with implementing EPAs, this article provides practical recommendations for how to implement EPAs for assessment and entrustment decisions in the workplace. Tips for supervising clinicians include talking to learners about trust, using EPA descriptions to guide learning and teaching, providing learners with greater ad hoc responsibilities, using EPAs to identify/create opportunities for assessment and feedback, including case-based discussions and acknowledging gut feelings about learner readiness for more autonomy. Tips for curriculum leaders entail enabling the trust development, applying trust decisions at all levels of the supervision scale, employing all available information sources for entrustment, empowering learner ownership of the assessment process and using technology for learner tracking and program evaluation.

Notes on contributors

Harm Peters, MD, is a Professor of Medical Education and Director of the Dieter Scheffner Center for Medical Education and Educational Research at the Charité – Universitätsmedizin Berlin, Germany.

Ylva Holzhausen MSc, PhD student, is working at the Dieter Scheffner Center for Medical Education and Educational Research at the Charité – Universitätsmedizin Berlin, Germany.

Christy K. Boscardin, PhD, is an Associate Professor, Department of Medicine, School of Medicine, University of California at San Francisco, USA.

Olle ten Cate, PhD, is a Professor of Medical Education and Director of the Center for Research and Development of Education at University Medical Center Utrecht, The Netherlands.

H. Carrie Chen, MD, PhD, at the time of this work, was a Professor of clinical pediatrics at the University of California San Francisco, USA, and visiting professor at the Center for Research and Development of Education at University Medical Center Utrecht, The Netherlands. She is currently professor of pediatrics and Associate Dean for Assessment and Educational Scholarship at Georgetown University School of Medicine, Washington, DC, USA.

Disclosure statement

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

Additional information

Funding

This publication was supported by a grant from the European Union Seventh Framework Programme for Research, Technological Development and Demonstration with the title “Workplace-based e-assessment technology for competency-based higher multi-professional education” (WATCHME, grant agreement No. 619349).