Entrustable Professional Activities in Residency Programs – planning and scheduling issues

Abstract

Residency programs allow residents, i.e., graduate physicians, to qualify for being a specialist in one of the medical disciplines. Their educational programme is strongly focusing on competencies and skills, but will incur a major change in the near future in order to introduce Entrustable Professional Activities (EPA's). EPA's focus on actual physician tasks and are assessed by supervisors in the clinic. The trust levels indicate whether trainees are ready for the next milestone, such as unsupervised practice, based on assessment of performance of those activities. EPA's have not only effect on the internships and the assessment process, but also impact the planning and scheduling of the educational programmes, internships, patient care services, and cooperation between regional hospitals. This study examines the effect on the planning and scheduling process and proposes a framework for planning and scheduling in order to facilitate the organization of this type of educational programs. The main improvements have to be found in an improved regional coordination between the hospitals, a more leading role for the educational programme directors, and more intelligent planning and scheduling.

An update on current EPAs in graduate medical education: A scoping review

“…One of the effects of EPAs is that they create uncertainty by affecting the development of competence and the frequency with which activities are performed, requiring more time to utilize and practice at the first stage. As a result, the process per se produces a great deal of stress among physicians and instructors [ 32 , 38 ]. It is also likely that residents may prioritize the EPAs over other important tasks and education[ 36 ].…”