Teacher entrustability in medical education: Navigating a complex landscape

In 2005, Olle ten Cate introduced the concept of Entrustable Professional Activities (EPAs) in the assessment of medical trainees in competency-based postgraduate training (ten Cate, 2005). Over the past two decades, EPAs have found their way into mainstream competency-based education and training for almost all health care professions, from medicine to pharmacy, nursing, dentistry, veterinary dietetics, and the physician assistant field (ten Cate, 2020). Although the terms 'entrustable' and later, 'entrustability', were defined as neologisms at the time, the concept of trust was not unfamiliar to clinicians who are continually required to manage risks in the inherently complex health care business and education (Damodaran et al. 2017). Patient trust in the doctor, the health care system and medical profession, and supervisor trust in the trainee are examples of interpersonal, social, and organizational levels of trust. Therefore, the language of trust and entrustability has offered a more authentic and practical vocabulary than that of competency (Damodaran et al. 2017).