Entrustable professional activities versus competencies and skills: Exploring why different concepts are often...

Area of Science:

• Medical Education
• Health Professions Education
• Competency-Based Medical Education

Background:

• Entrustable Professional Activities (EPAs) are frequently conflated with competencies and skills in medical education literature.
• This confusion hinders clear understanding and effective implementation of EPAs.
• The distinction is vital for accurate assessment, learner progression, and patient safety.

Purpose of the Study:

• To analyze the causes of confusion between EPAs, competencies, and skills.
• To emphasize the importance of distinguishing EPAs from competencies and skills.
• To propose solutions for educational objectives not easily framed as EPAs.

Main Methods:

• Conceptual analysis of EPAs, competencies, and skills.
• Examination of entrustment decisions in healthcare education.
• Literature review on the application and understanding of EPAs.

Main Results:

• Confusion arises from framing all educational objectives as EPAs and misinterpreting entrustment decisions.
• 'Skills' colloquially refer to activities, while the actual skill is the ability to perform them.
• Entrustment decisions, when solely for advancement, can devalue EPAs as mere 'tick boxes'.

Conclusions:

• Clear differentiation between EPAs and competencies/skills is essential for effective medical training.
• Addressing the causes of confusion will preserve the integrity and purpose of EPAs.
• Properly understanding EPAs supports genuine qualification and enhances patient safety.