Can Teachers Distinguish Competencies From Entrustable Professional Activities?

There has been a recent transition from the use of "competencies" to "entrustable professional activities" (EPAs) in medical education assessment paradigms. Although this transition proceeds apace, few studies have examined these concepts in a practical context. Our study sought to examine how distinct the concepts of competencies and EPAs were to front-line clinical educators.

A 20-item survey tool was developed based on the University of Calgary Department of Family Medicine's publicly available lists of competencies and EPAs. This tool required participants to identify given items as either a competency or an EPA, after reading a description of each. The tool was administered to a convenience sample of consenting clinical educators at 5 of the 14 training sites at the University of Toronto Department of Family and Community Medicine in 2018. We also collected information on years in practice, hours spent supervising per week, and direct involvement in medical education.

We analyzed a total of 60 surveys. The mean rate of correct responses was 45.3% (+/- 21.8%). Subgroup analysis failed to reveal any correlation between any of the secondary characteristics and correct responses.

Clinical educators in our study were not able to distinguish between competencies and EPAs. Further research is recommended prior to intensive curricular changes.