Entrustment in physician-patient communication: a modified Delphi study using the EPA approach

Area of Science:

• Medical Education
• Communication Skills
• Healthcare Assessment

Background:

• Competency-based curricula globally emphasize effective physician-patient communication.
• Current training often lacks clear links between communication competencies and practical application, causing implementation and assessment challenges.
• Entrustable Professional Activities (EPAs) offer a solution by defining specific, observable tasks for assessment.

Purpose of the Study:

• To develop a competency-based framework for assessing physician-patient communication.
• To define specific patient communication tasks as EPAs.
• To align assessment with practical application in medical training.

Main Methods:

• A modified Delphi study involving three stages.
• Stage 1: Literature review to identify communication-related EPAs.
• Stage 2: Content validation by medical education experts.
• Stage 3: Three iterative Delphi rounds with consensus levels and McNemar test for stability.

Main Results:

• Development of 4 specific EPAs for physician-patient communication, targeting unsupervised practice (Level 5).
• EPAs include: Providing information, Breaking Bad News, Counseling, and Conflict Resolution.
• Each EPA is linked to specific competencies and assessment strategies.

Conclusions:

• EPAs provide an integrative, competency-based assessment framework for patient-centered care.
• Standardizing communication through EPAs enhances physician-patient interaction quality.
• EPAs are adaptable for postgraduate curricula globally, serving as assessment and self-assessment tools.