Implementing an Entrustable Professional Activities Framework in Undergraduate Medical Education: Early Lessons From the AAMC Core Entrustable Professional Activities for Entering Residency Pilot

Abstract

In 2014, the Association of American Medical Colleges (AAMC) published a list of 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs) that medical school graduates might be expected to perform, without direct supervision, on the first day of residency. Soon after, the AAMC commissioned a five-year pilot with 10 medical schools across the United States, seeking to implement the Core EPA framework to improve the transition from undergraduate to graduate medical education.In this article, the pilot team presents the organizational structure and early results of collaborative efforts to provide guidance to other institutions planning to implement the Core EPA framework. They describe the aims, timeline, and organization of the pilot as well as findings to date regarding the concepts of entrustment, assessment, curriculum development, and faculty development. On the basis of their experiences over the first two years of the pilot, the authors offer a set of guiding principles for institutions intending to implement the Core EPA framework. They also discuss the impact of the pilot, its limitations, and next steps, as well as how the pilot team is engaging the broader medical education community. They encourage ongoing communication across institutions to capitalize on the expertise of educators to tackle challenges related to the implementation of this novel approach and to generate common national standards for entrustment. The Core EPA pilot aims to better prepare medical school graduates for their professional duties at the beginning of residency with the ultimate goal of improving patient care.

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

“…Chen et al stated that at the beginning of the training, the EPAs should represent smaller tasks, and the more experienced a trainee is, the broader the EPAs can be [14]. However, it was also stated that sometimes, an ad hoc entrustment for a full EPA, such as inpatient admission, as described by Lomis et al [15], was possible for simple treatments. Diagnosing or treating more complex diseases were seldom entrusted due to supervisor or student uncertainty.…”

Assessing Entrustable Professional Activities Using an Orientation OSCE: Identifying the Gaps

“…1 While it is impossible to create a uniform curriculum for all medical schools, the Association of American Medical Colleges (AAMC) describes 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs) every graduate should be expected to perform proficiently on the first day of residency. [2][3][4] Each training program's intern cohort is comprised of individuals from different medical schools that place varying levels of emphasis on CEPAER development and assessment.…”

Entrustable Professional Activities in final year undergraduate medical training – advancement of the final year training logbook in Germany

“…The EPA concept is internationally recognized in postgraduate medical training, and also receives increasing attention in undergraduate medical education [9], [10], [11]. However, up to now, there have only been very few case studies on its implementation and the achieved effects [12], [13]. …”