Entrustable Professional Activities and Learning: The Postgraduate Trainee Perspective

Area of Science:

• Medical Education
• Psychiatry Training
• Competency-Based Education

Background:

• Entrustable professional activities (EPAs) are integral to postgraduate psychiatry training in Australasia.
• Understanding trainee perceptions of EPAs is crucial for optimizing their educational impact.

Purpose of the Study:

• To explore psychiatry trainees' perceptions of how EPAs influence their motivation and learning.
• To identify factors mediating the relationship between EPAs and trainee engagement.

Main Methods:

• A constructivist grounded theory approach was employed.
• Data were collected through semi-structured individual interviews with a purposive sample of trainees in New Zealand.
• Data collection continued until theoretical saturation was achieved.

Main Results:

• Trainee appraisals of subjective control, value, and costs mediated the impact of EPAs on learning.
• Positive appraisals led to focused learning and structured supervision, while negative appraisals resulted in superficial learning.
• EPA granularity, clinical practice alignment, and supervisor conscientiousness significantly influenced trainee appraisals and learning outcomes.

Conclusions:

• EPAs must be perceived as a coherent curriculum by trainees and supervisors to stimulate learning.
• Valuing EPAs as a work-based curriculum encompassing fellowship competencies is essential.
• Prioritizing ongoing faculty development is critical for effective EPA implementation in clinical learning.